Diseases | |
Progressive Immunodeficiency with Gradual Depletion of B and CD4+ T Cells in Immunodeficiency, Centromeric Instability and Facial Anomalies Syndrome 2 (ICF2) | |
ReinholdE. Schmidt1  Natalia Dubrowinskaja1  Diana Ernst1  Georgios Sogkas1  Faranaz Atschekzei1  Alexandra Jablonka1  Jana Lentes2  AnkeK. Bergmann2  Tim Ripperger2  Ulrich Baumann3  Robert Geffers4  Mykola Fedchenko5  | |
[1] Department of Clinical Immunology and Rheumatology, Hannover Medical School, 30625 Hannover, Germany;Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany;Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, 30625 Hannover, Germany;Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany;Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany; | |
关键词: ICF syndrome; B cell immunodeficiency; T cell immunodeficiency; combined immunodeficiency; ICF2; ZBTB24; | |
DOI : 10.3390/diseases7020034 | |
来源: DOAJ |
【 摘 要 】
Immunodeficiency, centromeric instability and facial anomalies syndrome 2 (ICF2) is a rare autosomal recessive primary immunodeficiency disorder. So far, 27 patients have been reported. Here, we present three siblings with ICF2 due to a homozygous ZBTB24 gene mutation (c.1222 T>G, p. (Cys408Gly)). Immune deficiency in these patients ranged from late-onset combined immunodeficiency (CID) with severe respiratory tract infections and recurrent shingles to asymptomatic selective antibody deficiency. Evident clinical heterogeneity manifested despite a common genetic background, suggesting the pathogenic relevance of epigenetic modification. Immunological follow-up reveals a previously unidentified gradual depletion of B and CD4+ T cells in all three presented patients with transition of a common variable immunodeficiency (CVID)-like disease to late-onset-CID in one of them. Considering all previously published cases with ICF2, we identify inadequate antibody responses to vaccines and reduction in CD27+ memory B cells as prevalent immunological traits. High mortality among ICF2 patients (20%) together with the progressive course of immunodeficiency suggest that hematopoietic stem cell transplantation (HSCT) should be considered as a treatment option in due time.
【 授权许可】
Unknown