Diagnosis of primary ciliary dyskinesia: When and how?

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Dec;134(6):377-382. doi: 10.1016/j.anorl.2017.04.001. Epub 2017 May 11.

Abstract

Introduction: Primary ciliary dyskinesia (PCD) is a rare congenital disorder involving permanent ubiquitous structural and/or functional ciliary abnormalities.

Methods: A single-center retrospective study included 56 cases of PCD (respiratory form) out of a cohort of 280 patients with suspected PCD. The main features of history-taking and clinical examination were analyzed, to formulate a pragmatic diagnostic procedure, easy to implement in clinical practice.

Results: Chronic respiratory tract infectious symptoms are sensitive but non-specific for the diagnosis of PCD. Nasal brushing for phase-contrast microscopy study of ciliary morphology and activity proved to be a fast, easy, non-invasive, cost-effective and age-independent diagnostic method. In doubtful cases, depending on local availability, further tests are indicated: nasal nitric oxide level, electronic microscopy, genetic study and cell culture.

Conclusions: In suspected PCD, there being no gold standard method of screening and early diagnosis, nasal brushing with ciliary study is contributive, alongside numerous other complementary tests, on condition that the clinician is experienced and results are interpreted in the light of clinical examination and history-taking.

Keywords: Immobile ciliary syndrome; Kartagener syndrome; Microscopy; Mucociliary clearance; Nasal brushing; Primary ciliary dyskinesia.

MeSH terms

  • Adult
  • Child, Preschool
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Humans
  • Kartagener Syndrome / diagnosis*
  • Male
  • Microscopy, Electron*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity