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Liquidano-Perez E, Maza-Ramos G, Perez Arias BA, Lugo Reyes SO, Barragan Arevalo T, Solorzano-Morales SA, Venegas Montoya E, Staines-Boone AT, Guzmán Cotaya R, Okada S, Picard C, Patin E, Ramirez-Uribe N, Bustamante-Ogando JC, Scheffler-Mendoza SC, Yamazaki-Nakashimada MA, Saez-de-Ocariz M, Espinosa Padilla SE, Gonzalez-Serrano ME. Clinical, immunological, and genetic description of a Mexican cohort of patients with DOCK8 deficiency. Pediatr Allergy Immunol 2024; 35:e14073. [PMID: 38351896 DOI: 10.1111/pai.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/16/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE We aimed to describe the clinical, immunological, and genetic features of patients with DOCK8 deficiency (DOCK8-Def) in a tertiary care center for children. METHODS Retrospective chart review of patients' clinical, immunological, and genetic characteristics with DOCK8-Def. Genetic analysis was performed with targeted- or whole-exome sequencing; we also assessed DOCK8 protein expression and a lymphoproliferation assay and analyzed survival by the Kaplan-Meier method. RESULTS We described 11 patients from 8 unrelated kindreds. The median age at symptoms' onset was 10 months (range 1-54 months). The median follow-up time was 53.4 months (4.8-118.8). All patients presented eczema and recurrent sinopulmonary and cutaneous infections. Besides those symptoms, the most frequent manifestations were bronchiectases (8/11), food allergies (6/11), and severe infections (6/11). Infrequent characteristics were detection of CMV in bronchial lavage, C. parvum-driven sclerosing cholangitis, Takayasu vasculitis, neurological syndromes, pulmonary tuberculosis, and lymphomatoid granulomatosis. CONCLUSION DOCK8-Def has a broad spectrum of manifestations, including allergy, autoimmunity, inflammation, infection, and cancer. The hallmark of this inborn error of immunity is IEI-associated eczema with eosinophilia and increased IgE. Here, we report six new mutations causing human DOCK8 deficiency and symptoms previously unrecognized to occur in DOCK8-Def. Therefore, an early diagnosis of DOCK8-Def is essential to facilitate an adequate treatment such as HSCT.
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Affiliation(s)
| | | | | | | | - Tania Barragan Arevalo
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | | | - Edna Venegas Montoya
- Highly Specialized Medical Unit 25, Mexican Social Security Institute, Torreón, Mexico
| | | | | | | | | | | | - Nideshda Ramirez-Uribe
- Hematopoietic Stem Cell Transplantation Unit, National Institute of Pediatrics, Mexico City, Mexico
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Yamazaki-Nakashimada MA, Herrera-Mora P, Mahrx-Bracho A, López-Herrera G, Bustamante-Ogando JC, Scheffler-Mendoza SC. Combined Treatment of Progressive Encephalitis in an X-linked Agammaglobulinemia Patient. Iran J Allergy Asthma Immunol 2023; 22:504-509. [PMID: 38085151 DOI: 10.18502/ijaai.v22i5.13999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/17/2023] [Indexed: 12/18/2023]
Abstract
Most patients with X-linked agammaglobulinemia are susceptible to infections, while some cases also suffer from inflammatory or autoimmune complications. We describe a patient with progressive encephalitis who improved after the use of immunomodulatory treatment with corticosteroids, fluoxetine, and nitazoxanide. In most of the cases the evolution of the progressive encephalitis is complicated and catastrophic. Based on our experience and the review of the literature, we propose the use of this combined treatment to control this devastating complication.
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Affiliation(s)
| | - Patricia Herrera-Mora
- Department of Pediatric Neurology, Instituto Nacional de Pediatria. Mexico City, Mexico.
| | - Alfonso Mahrx-Bracho
- Department of Pediatric Neurosurgery, Instituto Nacional de Pediatria. Mexico City, Mexico.
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Carrillo-Tapia E, García-García E, Herrera-González NE, Yamazaki-Nakashimada MA, Staines-Boone AT, Segura-Mendez NH, Scheffler-Mendoza SC, O Farrill-Romanillos P, Gonzalez-Serrano ME, Rodriguez-Alba JC, Santos-Argumedo L, Berron-Ruiz L, Sanchez-Flores A, López-Herrera G. Delayed diagnosis in X-linked agammaglobulinemia and its relationship to the occurrence of mutations in BTK non-kinase domains. Expert Rev Clin Immunol 2017; 14:83-93. [PMID: 29202590 DOI: 10.1080/1744666x.2018.1413349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND X-linked agammaglobulinemia (XLA) is characterized by the absence of immunoglobulin and B cells. Patients suffer from recurrent bacterial infections from early childhood, and require lifelong immunoglobulin replacement therapy. Mutations in BTK (Bruton's Tyrosine Kinase) are associated with this phenotype. Some patients that present XLA do not show typical clinical symptoms, resulting in delayed diagnosis due to the lack of a severe phenotype. This study presents a report of five XLA patients from four different families and attempts to determine a relationship between delayed diagnosis and the occurrence of BTK mutations. METHODS Samples from patients with antibody deficiency were analyzed to determine BTK expression, immunophenotyping and mutation analysis. Clinical and laboratory data was analyzed and presented for each patient. RESULTS Most patients presented here showed atypical clinical and laboratory data for XLA, including normal IgM, IgG, or IgA levels. Most patients expressed detectable BTK protein. Sequencing of BTK showed that these patients harbored missense mutations in the pleckstrin homology and Src-homology-2 domains. When it was compared to public databases, BTK sequencing exhibited a new change, along with three other previously reported changes. CONCLUSIONS Delayed diagnosis and atypical manifestations in XLA might be related to mutation type and BTK expression.
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Affiliation(s)
- Eduardo Carrillo-Tapia
- a Unidad de Investigación en Inmunodeficiencias , Instituto Nacional de Pediatría, SSA , Ciudad de México , Mexico.,b Posgrado en Ciencias de la Salud, Escuela Superior de Medicina , Instituto Politécnico Nacional , Ciudad de México , Mexico.,c Programa en Ciencias Genómicas , Universidad Autónoma de la Ciudad de México , Mexico
| | - Elizabeth García-García
- a Unidad de Investigación en Inmunodeficiencias , Instituto Nacional de Pediatría, SSA , Ciudad de México , Mexico
| | - Norma Estela Herrera-González
- b Posgrado en Ciencias de la Salud, Escuela Superior de Medicina , Instituto Politécnico Nacional , Ciudad de México , Mexico
| | | | - Aidee Tamara Staines-Boone
- e Departamento Inmunología Clínica , Centro Médico Nacional del Noreste, Unidad Médica de alta especialidad IMSS 25 , Monterrey , NL , Mexico
| | - Nora Hilda Segura-Mendez
- f Servicio de alergia e Inmunologia Clínica , Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS , Ciudad de México , Mexico
| | | | - Patricia O Farrill-Romanillos
- f Servicio de alergia e Inmunologia Clínica , Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS , Ciudad de México , Mexico
| | - Maria E Gonzalez-Serrano
- a Unidad de Investigación en Inmunodeficiencias , Instituto Nacional de Pediatría, SSA , Ciudad de México , Mexico
| | - Juan Carloa Rodriguez-Alba
- g Departamento de Biomedicina , Instituto de Ciencias de la Salud, Universidad Veracruzana , Xalapa Ver , Mexico
| | - Leopoldo Santos-Argumedo
- h Biomedicina Molecular , Centro de Investigación y de Estudios Avanzados , Ciudad de México , Mexico
| | - Laura Berron-Ruiz
- a Unidad de Investigación en Inmunodeficiencias , Instituto Nacional de Pediatría, SSA , Ciudad de México , Mexico
| | - Alejandro Sanchez-Flores
- i Unidad Universitaria de Secuenciación Masiva y Bioinformática. Instituto de Biotecnología, Universidad Nacional Autónoma de México. Cuernavaca Morelos , Mexico
| | - Gabriela López-Herrera
- a Unidad de Investigación en Inmunodeficiencias , Instituto Nacional de Pediatría, SSA , Ciudad de México , Mexico
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Rodríguez-González M, Lugo-Reyes SO, Venegas-Montoya E, Scheffler-Mendoza SC. Fragmentos de memoria inmunológica: entrevista al doctor Renato Berrón. RAM 2017; 64:509-512. [DOI: 10.29262/ram.v64i4.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
El doctor Renato Daniel Berrón Pérez fundó el Departamento de Inmunología Clínica del Instituto Nacional de Pediatría. Nació el 17 de octubre de 1934 y falleció el 13 de febrero del 2017, en la Ciudad de México. Su color favorito era el rojo. Vivía con su querida esposa Martha Yolanda. Tuvo 8 hijos y 8 nietos. Era dueño de un perro Schnauzer llamado "Diva". Actualmente en México existen alrededor de 800 médicos alergólogos/inmunólogos clínicos gracias al campo que abrió el doctor Berrón, como resultado de circunstancias y suerte en una vida muy interesante. Este es el principio de nuestra historia
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Scheffler-Mendoza SC, Partida-Gaytan A, Leal-Leal C, Rodríguez Jurado R. Adolescente femenino con granulomatosis de Wegener fulminante. Acta Pediatr Mex 2017. [DOI: 10.18233/apm1no1pp33-481322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Adolescente femenino de 13 años de edad, originaria de Guerrero, grupo étnico mixteco, padres analfabetos y con poco entendimiento del español. Sin otros antecedentes de importancia para el padecimiento. Inició un mes previo con la aparición de una pápula hipercrómica en párpado superior derecho que en los 10 días previos al ingreso aumentó de volumen generando proptosis. Al interrogatorio se negó dolor, lagrimeo, fiebre, o pérdida de peso. Ingresó con fiebre (39.0°C), palidez generalizada, proptosis derecha con exposición de córnea y conjuntiva, eritema periorbitario, movimientos oculares y agudeza visual disminuidos (i.e. contaba dedos a 1 m), pupila con tendencia a midriasis, hiperreactividad a la luz, y fondo de ojo con papila hiperémica edematosa y tortuosidad peripapilar. El resto de exploración no mostró datos relevantes. Se hospitalizó para iniciar tratamiento antimicrobiano parenteral de amplio espectro (i.e. ceftriaxona y vancomicina) y abordar proptosis unilateral.
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