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ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia

Jayesh M. Bhatt, Andrew Bush, Marjo van Gerven, Andreea Nissenkorn, Michael Renke, Lian Yarlett, Malcolm Taylor, Thomy Tonia, Adilia Warris, Stefan Zielen, Shairbanu Zinna, Peter J.F.M. Merkus
European Respiratory Review 2015 24: 565-581; DOI: 10.1183/16000617.0066-2015
Jayesh M. Bhatt
1Nottingham Children's Hospital, UK Paediatric National Clinic, Nottingham University Hospitals NHS Trust, Nottingham, UK
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  • For correspondence: jayeshbhatt@hotmail.com
Andrew Bush
2Imperial College and Royal Brompton Hospital, London, UK
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Marjo van Gerven
3Dept of Paediatrics, Division of Respiratory Medicine, Amalia Children's Hospital Radboud, University Medical Centre, Nijmegen, The Netherlands
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Andreea Nissenkorn
4Rare Diseases Service and Pediatric Neurology Unit, Edmond and Lilly Safra Pediatric Hospital, Sheba Medical Center, Tel HaShomer, Israel
5Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Michael Renke
6Dept of Allergology, Pneumology and Cystic Fibrosis, Children's Hospital, Goethe-University Theodor-Stern Kai, Frankfurt/Main, Germany
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Lian Yarlett
7The A-T Society, IACR-Rothamsted, Harpenden, UK
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Malcolm Taylor
8School of Cancer Sciences, University of Birmingham, Birmingham, UK
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Thomy Tonia
9Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Adilia Warris
10Institute of Medical Sciences, University of Aberdeen and the Royal Aberdeen Children's Hospital, Aberdeen, UK
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Stefan Zielen
6Dept of Allergology, Pneumology and Cystic Fibrosis, Children's Hospital, Goethe-University Theodor-Stern Kai, Frankfurt/Main, Germany
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Shairbanu Zinna
1Nottingham Children's Hospital, UK Paediatric National Clinic, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Peter J.F.M. Merkus
3Dept of Paediatrics, Division of Respiratory Medicine, Amalia Children's Hospital Radboud, University Medical Centre, Nijmegen, The Netherlands
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Abstract

Ataxia telangiectasia (A-T) is a rare, progressive, multisystem disease that has a large number of complex and diverse manifestations which vary with age. Patients with A-T die prematurely with the leading causes of death being respiratory diseases and cancer. Respiratory manifestations include immune dysfunction leading to recurrent upper and lower respiratory infections; aspiration resulting from dysfunctional swallowing due to neurodegenerative deficits; inefficient cough; and interstitial lung disease/pulmonary fibrosis. Malnutrition is a significant comorbidity. The increased radiosensitivity and increased risk of cancer should be borne in mind when requesting radiological investigations. Aggressive proactive monitoring and treatment of these various aspects of lung disease under multidisciplinary expertise in the experience of national multidisciplinary clinics internationally forms the basis of this statement on the management of lung disease in A-T. Neurological management is outwith the scope of this document.

Abstract

Complex respiratory manifestations in ataxia telangiectasia require regular, proactive multidisciplinary management http://ow.ly/Solqe

Footnotes

  • For editorial comments see Eur Respir J 2015; 46: 1557–1560 [DOI: 10.1183/13993003.01456-2015].

  • Conflict of interest: None declared.

  • Provenance: Submitted article, peer reviewed.

  • Received September 1, 2015.
  • Accepted September 8, 2015.
  • Copyright ©ERS 2015.

ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia
Jayesh M. Bhatt, Andrew Bush, Marjo van Gerven, Andreea Nissenkorn, Michael Renke, Lian Yarlett, Malcolm Taylor, Thomy Tonia, Adilia Warris, Stefan Zielen, Shairbanu Zinna, Peter J.F.M. Merkus
European Respiratory Review Dec 2015, 24 (138) 565-581; DOI: 10.1183/16000617.0066-2015

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ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia
Jayesh M. Bhatt, Andrew Bush, Marjo van Gerven, Andreea Nissenkorn, Michael Renke, Lian Yarlett, Malcolm Taylor, Thomy Tonia, Adilia Warris, Stefan Zielen, Shairbanu Zinna, Peter J.F.M. Merkus
European Respiratory Review Dec 2015, 24 (138) 565-581; DOI: 10.1183/16000617.0066-2015
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  • Article
    • Abstract
    • Abstract
    • Introduction
    • Methods
    • Phenotypes of respiratory disease in A-T
    • Immune deficiency
    • Interstitial lung disease
    • Respiratory monitoring
    • Sleep-related breathing disorder
    • Cough and mucociliary clearance
    • Genotype/phenotype correlation in A-T
    • Nutritional effects on lung disease and immune function
    • Dyscoordinate swallowing, aspiration, gastro-oesophageal reflux and gastrostomy
    • Scoliosis in A-T
    • Risks of diagnostic radiation in A-T
    • Cancer in A-T
    • Perioperative management of a patient with A-T undergoing surgery
    • Organisation of care for lung disease in A-T
    • Footnotes
    • References
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  • PDF

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