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American Journal of Respiratory and Critical Care Medicine Vol 169. pp. 634-637, (2004)
© 2004 American Thoracic Society


Case Report

Central Microtubular Agenesis Causing Primary Ciliary Dyskinesia

Wendy Stannard, Andrew Rutman, Colin Wallis and Chris O'Callaghan

Division of Child Health, Institute of Lung Health, Department of Infection, Immunity, and Inflammation, University of Leicester, Leicester; and Great Ormond Street Hospital for Children, London, United Kingdom

Correspondence and requests for reprints should be addressed to Chris O'Callaghan, F.R.C.P., F.R.C.P.C.H., D.M., Ph.D., Division of Child Health, Institute of Lung Health, Department of Infection, Immunity, and Inflammation, University of Leicester, Robert Kilpatrick Clinical Sciences Building, PO Box 65, Leicester Royal Infirmary, Leicester LE2 7LX, UK. E-mail: ajb64{at}le.ac.uk

ABSTRACT

Primary ciliary dyskinesia is an autosomal recessive disorder characterized by chronic upper and lower respiratory tract symptoms. We report the diagnosis of primary ciliary dyskinesia associated with a circular ciliary beat pattern in three siblings. This beat pattern is consistent with a ciliary transposition defect, where a peripheral microtubule doublet is transposed to the center of the ciliary axoneme to replace the absent central microtubule pair. However, in these siblings, ultrastructural analysis of the cilia revealed an absence of the central microtubule pair only. This variant of transposition with a circular ciliary beat pattern has not been described previously. In addition, this defect, together with the transposition defect, may help explain the mechanism of the circular beat pattern and also the absence of situs inversus in these patients.

Key Words: ciliary motility disorders • primary ciliary dyskinesia • bronchiectasis • respiratory epithelium • cilia




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