1
|
Wyatt EK, Affolter V, Borio S, Guillen A, Verganti S, Murphy S, Ballarini D, Banovic F, Schmidt V, Tanis JB. Mastocytosis in the skin in dogs: A multicentric case series. Vet Comp Oncol 2024; 22:136-148. [PMID: 38243867 DOI: 10.1111/vco.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
Canine cutaneous mastocytosis (CM) is rare in contrast to canine mast cell tumours. In humans, CM commonly affects children and is usually indolent with possible spontaneous resolution. Systemic mastocytosis (SM) with bone marrow involvement typically affects adults, can have a poor outcome, and often includes skin lesions. 'Mastocytosis in the skin' (MIS) is the preferred term of skin lesions, if bone marrow evaluations are not available, which is often the cases in dogs. In human SM and CM, KIT mutations are often detected. The veterinary literature suggests clinical resemblances between human and canine MIS, but data is limited, and KIT mutations are rarely assessed. This retrospective study describes clinicopathological findings, treatment and outcome of 11 dogs with suspected MIS. Dogs with multiple mast cell tumours were excluded. Histopathology reports (n = 5) or slides (n = 6) were reviewed. KIT mutation analysis including exons 8, 9, 11, 14 and 17 were analysed in eight dogs. Median age at diagnosis was 4 years (range, 1-12). Typical clinical signs included multifocal to generalised nodules and papules. Histologically, skin lesions were characterised by dermal infiltration of well-differentiated mast cells. KIT mutations were detected in 3/8 dogs (exon 9: n = 2; exon 11: n = 1). One dog had mastocytaemia suggesting possible SM. Glucocorticoids were mostly successful with lesion improvement in all treated dogs (n = 8). This cohort highlights resemblances between human and canine MIS. Further studies are required to confirm these findings and establish diagnostic criteria for CM and MIS associated with SM in dogs.
Collapse
Affiliation(s)
- Eleanor K Wyatt
- Department of Small Animal Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Verena Affolter
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Stefano Borio
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Alexandra Guillen
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Sara Verganti
- Oncology Service, Dick White Referrals, Six Mile Bottom, UK
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, UK
| | - Sue Murphy
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, UK
- College of Medicine & Veterinary Medicine, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK
| | | | - Frane Banovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Vanessa Schmidt
- Department of Small Animal Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Jean-Benoit Tanis
- Department of Small Animal Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| |
Collapse
|
2
|
Kawaguchi T, Okanishi T, Okazaki T, Aoki C, Kasagi N, Adachi K, Yoshida Y, Miyake N, Matsumoto N, Maegaki Y. Mastocytosis in a Case of Noonan Syndrome Caused by a De Novo Pathogenic CBL Variant. Yonago Acta Med 2023; 66:463-466. [PMID: 38028263 PMCID: PMC10674059 DOI: 10.33160/yam.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023]
Abstract
Noonan syndrome is an autosomal dominant disease characterized by multi-organ disorders caused by variants of genes involved in the RAS/MAPK signaling pathway. The nine causative genes including PTPN11 and CBL have been identified. Mastocytosis is a disease characterized by mast cell proliferation in skin, bone marrow, and other organs. To date, no previous cases of Noonan syndrome with mastocytosis caused by a pathogenic CBL variant have been reported. A boy was diagnosed with Noonan syndrome at 8 months of age with facial features and minor anomaly of his body. He presented with brown nodules of 5-10 mm on his body since the age of 2 months. The patient was diagnosed with mastocytosis by a biopsy specimen from brown nodules, which showed infiltration of mast cells. Whole-exome sequencing of the parent-patient trio revealed a de novo pathogenic CBL variant. The occurrence of mastocytosis may be a cue for the analysis of the CBL gene in Noonan syndrome. The CBL gene is involved in mastocytosis and various cancers. In the case of the pathogenic variant, long-term follow-up for the risk of cancers related to the CBL variant is necessary.
Collapse
Affiliation(s)
- Tatsuya Kawaguchi
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tohru Okanishi
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tetsuya Okazaki
- Division of Clinical Genetics, Tottori University Hospital, Yonago 683-8504, Japan
| | - Chisako Aoki
- Division of Clinical Genetics, Tottori University Hospital, Yonago 683-8504, Japan
| | - Noriko Kasagi
- Division of Clinical Genetics, Tottori University Hospital, Yonago 683-8504, Japan
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine Tottori University, Yonago 683-8504, Japan
| | - Kaori Adachi
- Division of Clinical Genetics, Tottori University Hospital, Yonago 683-8504, Japan
- Research Initiative Center, Organization for Research Initiative and Promotion, Tottori University, Yonago 683-8503, Japan
| | - Yuichi Yoshida
- Division of Dermatology, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Noriko Miyake
- Department of Human Genetics, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
- Division of Clinical Genetics, Tottori University Hospital, Yonago 683-8504, Japan
| |
Collapse
|
3
|
Abstract
To a large extent, the clinical picture of pediatric mastocytosis depends on the age at which it is diagnosed. A neonate with diffuse cutaneous mastocytosis may frequently present in a severe state requiring treatment. Toddlers may require long-term anti-mediator therapy, and this may lead to concerns such as organizing preschool education due to the need for epinephrine injections. A teenager may have to face cutaneous disease persistence or a diagnosis of systemic mastocytosis. Further studies are needed to refine the available treatment options and prognosis for different age groups.
Collapse
Affiliation(s)
- Joanna Renke
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, ul. Skłodowskiej-Curie 3A, 80-210 Gdańsk.
| | - Ninela Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, ul. Skłodowskiej-Curie 3A, 80-210 Gdańsk
| | - Magdalena Lange
- Department of Dermatology, Venerology and Allergology, Medical University of Gdańsk, ul. Skłodowskiej-Curie 3A, 80-210 Gdańsk
| |
Collapse
|
4
|
Larouche V, Paré MF, Grenier PO, Wieckowska A, Gagné E, Laframboise R, Jabado N, De Bie I. A Review of the Clinical Features and Management of Systemic Congenital Mastocytosis through the Presentation of An Unusual Prenatal-Onset Case. Curr Oncol 2023; 30:8992-9003. [PMID: 37887549 PMCID: PMC10605361 DOI: 10.3390/curroncol30100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/23/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023] Open
Abstract
Mastocytosis is a heterogeneous group of rare hematological disorders that can occur in infancy. We report a 16-year-old girl who presented with an aggressive form of systemic congenital mastocytosis, associated with a significant global developmental delay, deafness, and multiple anomalies. At 4 years of age, she developed a germinoma presenting as an invasive spinal mass. Extensive cytogenetic, metabolic, and molecular genetic studies that included whole-exome sequencing studies revealed a KIT alteration (NM_000222.3(KIT):c2447A > 7 pAsp816Val) and likely pathogenic variant in the DNA from peripheral blood and skin lesions. C-kit was also found to be overexpressed in the spinal tumor cells. We compared the features of this child to those of six previously reported pediatric patients with cutaneous mastocytosis, microcephaly, microtia, and/or hearing loss reported in OMIM as mastocytosis, conductive hearing loss, and microtia (MIM 248910), for which the etiology has not yet been determined. This report extends the currently recognized spectrum of KIT-related disorders and provides clues as to the potential etiology of a syndromic form of congenital mastocytosis. International efforts to understand the benefits of long-term targeted therapy with tyrosine kinase inhibitors for this KIT-altered rare disease should continue to be evaluated in clinical trials.
Collapse
Affiliation(s)
- Valérie Larouche
- Department of Pediatric Hemato-oncology, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec, QC G1V4G2, Canada
| | | | - Pierre-Olivier Grenier
- Department of Dermatology, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec, QC G1V4G2, Canada
| | - Anna Wieckowska
- Departement of Pediatric, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec, QC G1V4G2, Canada
| | - Eric Gagné
- Department of Pathology, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec, QC G1V4G2, Canada
| | - Rachel Laframboise
- Department of Medical Genetics, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec, QC G1V4G2, Canada
| | - Nada Jabado
- Department of Pediatric Hemato-Oncology, Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC G1V4G2, Canada
| | - Isabelle De Bie
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, QC G1V4G2, Canada
| |
Collapse
|
5
|
Brazzelli V, Bossi G, Bonelli A, Isoletta E, Volontè M, Barruscotti S, De Amici M, Bono E, Ferrari J, Boveri E. A case of pediatric indolent systemic mastocytosis: The role of UVB-NB phototherapy in the treatment of cutaneous lesions. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:540-542. [PMID: 37326545 DOI: 10.1111/phpp.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Valeria Brazzelli
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Grazia Bossi
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alice Bonelli
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Eugenio Isoletta
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Martina Volontè
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Mara De Amici
- Laboratory of Immuno- Allergology of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elisa Bono
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jacqueline Ferrari
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Emanuela Boveri
- Anatomy Pathology Section, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
6
|
Yuksel Bulut H, Ulusoy Severcan E, Ertugrul A. COVID-19 Vaccines Are Safely Tolerated in Adolescents with Cutaneous Mastocytosis. Int Arch Allergy Immunol 2023; 184:776-782. [PMID: 37071972 DOI: 10.1159/000530125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/09/2023] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION The management of the COVID-19 vaccine in children with mastocytosis is unclear due to a lack of data. In the current study, we aimed to evaluate the adverse reactions following COVID-19 vaccination in adolescents with cutaneous mastocytosis (CM). METHODS This study included 27 paediatric patients who were diagnosed with CM and were followed up in the paediatric allergy department of a tertiary care children's hospital. RESULTS The median (IQR) age of the patients at the time of COVID-19 vaccination was 180 (156-203) months. Forty-four per cent of patients were vaccinated with the COVID-19 vaccine. Among all participants, the vaccination rate was found to be higher in older children, those who had been diagnosed with MPCM, and those who had not been infected with COVID-19 (p = 0.019, p = 0.009, p = 0.002, respectively). A total of 23 doses of the COVID-19 vaccine, including two doses of Sinovac/CoronaVac and 21 doses of Pfizer/BioNTech, were administered to 12 paediatric patients with CM. One of the patients had a history of intense itch, erythematous urticarial plaques, and had an exacerbation of existing skin lesions within 24-48 h after both doses of Pfizer/BioNTech vaccination. CONCLUSION The COVID-19 vaccination of patients with CM in this series seems to be safe, and the rate of adverse events was comparable to that in the general population. These results found in adolescents with CM are in line with the existing evidence that CM does not preclude vaccination in children.
Collapse
Affiliation(s)
- Hande Yuksel Bulut
- Division of Immunology and Allergy, Department of Pediatrics, University of Health Sciences/Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Ezgi Ulusoy Severcan
- Division of Immunology and Allergy, Department of Pediatrics, University of Health Sciences/Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Aysegul Ertugrul
- Division of Immunology and Allergy, Department of Pediatrics, University of Health Sciences/Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| |
Collapse
|
7
|
Popadic S, Lalosevic J, Lekic B, Gajić-Veljic M, Bonaci-Nikolic B, Nikolic M. Mastocytosis in children: a single-center long-term follow-up study. Int J Dermatol 2023; 62:616-620. [PMID: 36807903 DOI: 10.1111/ijd.16612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/29/2022] [Accepted: 01/20/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Mastocytosis is a heterogeneous group of rare disorders characterized by the accumulation of clonal mast cells in organs such as the skin and bone marrow. The diagnosis of cutaneous mastocytosis (CM) is based on clinical findings, positive Darier's sign, and histopathology, if necessary. METHODS Medical records of 86 children with CM diagnosed during a 35-year long period were reviewed. Most patients (93%) developed CM during the first year of life (median age 3 months). Clinical features at presentation and during the follow-up period were analyzed. Baseline serum tryptase level was measured in 28 patients. RESULTS A total of 85% of patients had maculopapular cutaneous mastocytosis/urticaria pigmentosa (MPCM/UP), 9% had mastocytoma, and 6% had diffuse cutaneous mastocytosis (DCM). Boy to girl ratio was 1.1:1. Fifty-four of 86 patients (63%) were followed from 2 to 37 years (median 13 years). Complete resolution was registered in 14% of mastocytoma cases, 14% of MCPM/UP, and in 25% of DCM patients. After the age of 18, skin lesion persisted in 14% mastocytoma, 7% MCPM/UP, and 25% children with DCM. Atopic dermatitis was diagnosed in 9.6% of patients with MPCM/UP. Three of 28 patients had elevated serum tryptase. Prognosis in all patients was good, and there were no signs of progression to systemic mastocytosis (SM). CONCLUSION To the best of our knowledge, our results represent the longest single-center follow-up study of childhood-onset CM. We found no complications of massive mast cell degranulation or progression to SM.
Collapse
Affiliation(s)
- Svetlana Popadic
- Clinic of Dermatovenereology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Jovan Lalosevic
- Clinic of Dermatovenereology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Branislav Lekic
- Clinic of Dermatovenereology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Mirjana Gajić-Veljic
- Clinic of Dermatovenereology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Branka Bonaci-Nikolic
- University of Belgrade School of Medicine, Belgrade, Serbia.,Clinic of Allergy and Immunology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milos Nikolic
- Clinic of Dermatovenereology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| |
Collapse
|