|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|5666585||1407821||2017||3 صفحه PDF||ندارد||دانلود کنید|
â¢Early onset splenomegaly and persistent EBV viremia are suspicious for PI3KÎ´ syndrome.â¢Flow cytometry reveals peculiar B and T cell subsets for PI3KÎ´ syndrome.â¢Normal IgG and IgM levels do not exclude PI3KÎ´ syndrome.
Heterozygous gain of function mutations in the gene encoding p110Î´ subunit of PI3K have been recently associated with activated PI3K-Î´ syndrome (APDS), a novel combined immune deficiency characterized by recurrent sinopulmonary infections, lymphopenia, reduced class-switched memory B cells, lymphadenopathy, CMV and/or EBV viremia and EBV-related lymphoma.Here we report a dominant gain of function PIK3CD mutation (E1021K) in a patient presenting with recurrent otitis media, massive splenomegaly, and persistent EBV-viraemia. The immunological studies showed low IgA level, but normal IgM, IgG, and normal antibody response to diphtheria and tetanus toxoid vaccination. Analysis of B lymphocyte subsets revealed abnormal expansion of transitional B cells, and low percentage of switched CD27+IgDâ and CD27+IgD+ memory B cells. Analysis of T cell compartment unveiled prevalence of terminally differentiated cells.This study suggests that PIK3CD gain of function mutations should be suspected despite incomplete phenotype in patients with early onset splenomegaly, persistent EBV viremia and abnormal B and T cell subsets despite normal IgG levels. Currently the optimal treatment is still debated, but prompt management can hopefully diminish incidence of severe long-lasting sequelae (i.e. bronchiectasis, ear and sinus damage).
Journal: Immunology Letters - Volume 190, October 2017, Pages 279-281