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Iyengar VV, Chougule A, Gowri V, Taur P, Bodhanwala M, Desai MM. Pediatric Pancytopenia and Monosomy 7: A Case Report of SAMD9L-Associated Disease. J Clin Immunol 2024; 44:43. [PMID: 38231353 DOI: 10.1007/s10875-023-01650-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/20/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Vaishnavi V Iyengar
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India
| | - Akshaya Chougule
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India
| | - Vijaya Gowri
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India
| | - Prasad Taur
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India
| | - Minnie Bodhanwala
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India
| | - Mukesh M Desai
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai, Maharashtra, 400012, India.
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Chougule A, Iyengar VV, Gowri V, Taur P, Madkaikar MR, Bodhanwala M, Desai MM. Cleavage-resistant RIPK1-induced autoinflammatory syndrome-A report of three generations with periodic fever and clinical response to colchicine. Int J Rheum Dis 2024; 27:e14837. [PMID: 37452601 DOI: 10.1111/1756-185x.14837] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
The clinical syndrome caused by cleavage-resistant RIPK1 is known as CRIA (Cleavage-resistant RIPK1-induced autoinflammatory) syndrome. We present a family with three generations affected by CRIA syndrome. Our index patient (P1), a boy born of a non-consanguineous marriage, developed recurrent episodes of fever after 5 months of age, with variable periodicity. His father (P2) and paternal grandmother also had periodic fever. At 23 months of age, P1 was diagnosed with renal biopsy-proven steroid-responsive nephrotic syndrome. His first visit to our center was at 2 years of age. At presentation, he had failure to thrive, microcytic hypochromic anemia, and elevated inflammatory markers and interleukin-6 levels. Amyloid A protein was elevated, serum creatinine was normal, and proteinuria resolved after addition of steroids. Next-generation sequencing showed heterozygous mutation (c.970G>A, p.Asp324His) in RIPK1. This mutation has been reported to cause CRIA syndrome. P2 and P1's asymptomatic younger brother had the same mutation. All the affected members showed variability with respect to frequency and duration of periodic fever as well as the age of onset. Both P1 and P2 had elevated amyloid A, with no evidence of renal dysfunction. P1 and P2 showed improvement in the intensity of fever spikes with colchicine treatment; however, both continue to have periodic fever.
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Affiliation(s)
- Akshaya Chougule
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Vaishnavi V Iyengar
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Vijaya Gowri
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Prasad Taur
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Manisha R Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR NIIH, Mumbai, India
| | - Minnie Bodhanwala
- Department of Paediatrics, B. J. Wadia Hospital for Children, Mumbai, India
| | - Mukesh M Desai
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
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Gowri V, Chougule A, Gupta M, Taur P, Iyengar VV, Sivasankaran M, Munirathnam D, Krishna S, Bargir UA, Dalvi A, Setia P, Jodhawat N, Shinde S, Prabhu SS, Bodhanwala M, Madkaikar MR, Desai MM. Clinical, immunological and molecular findings of patients with DOCK-8 deficiency from India. Scand J Immunol 2023:e13276. [PMID: 37114940 DOI: 10.1111/sji.13276] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/08/2023] [Accepted: 04/25/2023] [Indexed: 04/29/2023]
Abstract
DOCK8 deficiency affects various cell subsets belonging to both innate and adaptive immune systems. Clinical diagnosis is challenging as many cases present with severe atopic dermatitis as the only initial manifestation. Though flow cytometry helps in presumptive diagnosis of DOCK8 deficient patients by evaluating their DOCK8 protein expression, it requires subsequent confirmation by molecular genetic analysis. Currently, hematopoietic stem cell transplantation (HSCT) is the only curative treatment option available for these patients. There is paucity of data from India on clinical diversity and molecular spectrum of DOCK8 deficiency. In the present study we report the clinical, immunological and molecular findings in 17 DOCK8-deficient patients from India diagnosed over last 5 years.
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Affiliation(s)
- Vijaya Gowri
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai
| | | | - Maya Gupta
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Prasad Taur
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai
| | | | | | | | | | - Umair A Bargir
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Aparna Dalvi
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Priyanka Setia
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Neha Jodhawat
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Shweta Shinde
- ICMR- National Institute of Immunohematology, Parel, Mumbai
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Iyengar VV, Chougule A, Gowri V, Taur P, Prabhu S, Bodhanwala M, Bargir UA, Madkaikar M, Desai MM. XMEN saved by magnesium. Scand J Immunol 2022; 95:e13154. [PMID: 35266176 DOI: 10.1111/sji.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/16/2022] [Accepted: 03/03/2022] [Indexed: 01/29/2023]
Affiliation(s)
- Vaishnavi V Iyengar
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Akshaya Chougule
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Vijaya Gowri
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Prasad Taur
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Shakuntala Prabhu
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Minnie Bodhanwala
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Umair A Bargir
- National Institute of Immunohaematology, ICMR, KEM Hospital, Mumbai, India
| | - Manisha Madkaikar
- National Institute of Immunohaematology, ICMR, KEM Hospital, Mumbai, India
| | - Mukesh M Desai
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
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Taur PD, Gowri V, Pandrowala AA, Iyengar VV, Chougule A, Golwala Z, Chandak S, Agarwal R, Keni P, Dighe N, Bodhanwala M, Prabhu S, George B, Fouzia NA, Edison ES, Arunachalam AK, Madkaikar MR, Dalvi AD, Yadav RM, Bargir UA, Kambli PM, Rawat A, Das J, Joshi V, Pilania RK, Jindal AK, Bhat S, Bhattad S, Unni J, Radhakrishnan N, Raj R, Uppuluri R, Patel S, Lashkari HP, Aggarwal A, Kalra M, Udwadia Z, Bafna VS, Kanade T, Puel A, Bustamante J, Casanova JL, Desai MM. Clinical and Molecular Findings in Mendelian Susceptibility to Mycobacterial Diseases: Experience From India. Front Immunol 2021; 12:631298. [PMID: 33732252 PMCID: PMC7959731 DOI: 10.3389/fimmu.2021.631298] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/02/2021] [Indexed: 01/26/2023] Open
Abstract
Mendelian Susceptibility to Mycobacterial diseases (MSMD) are a group of innate immune defects with more than 17 genes and 32 clinical phenotypes identified. Defects in the IFN-γ mediated immunity lead to an increased susceptibility to intracellular pathogens like mycobacteria including attenuated Mycobacterium bovis-Bacillus Calmette-Guérin (BCG) vaccine strains and non-tuberculous environmental mycobacteria (NTM), Salmonella, fungi, parasites like Leishmania and some viruses, in otherwise healthy individuals. Mutations in the IL12RB1 gene are the commonest genetic defects identified. This retrospective study reports the clinical, immunological, and molecular characteristics of a cohort of 55 MSMD patients from 10 centers across India. Mycobacterial infection was confirmed by GeneXpert, Histopathology, and acid fast bacilli staining. Immunological workup included lymphocyte subset analysis, Nitro blue tetrazolium (NBT) test, immunoglobulin levels, and flow-cytometric evaluation of the IFN-γ mediated immunity. Genetic analysis was done by next generation sequencing (NGS). Disseminated BCG-osis was the commonest presenting manifestation (82%) with a median age of presentation of 6 months due to the practice of BCG vaccination at birth. This was followed by infection with Salmonella and non-typhi Salmonella (13%), Cytomegalovirus (CMV) (11%), Candida (7%), NTM (4%), and Histoplasma (2%). Thirty-six percent of patients in cohort were infected by more than one organism. This study is the largest cohort of MSMD patients reported from India to the best of our knowledge and we highlight the importance of work up for IL-12/IL-23/ISG15/IFN-γ circuit in all patients with BCG-osis and suspected MSMD irrespective of age.
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Affiliation(s)
- Prasad D Taur
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Vijaya Gowri
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | | | | | - Akshaya Chougule
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Zainab Golwala
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Shraddha Chandak
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Reepa Agarwal
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Purva Keni
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Neha Dighe
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Minnie Bodhanwala
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Shakuntala Prabhu
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Biju George
- Department of Clinical Hematology, Christian Medical College, Vellore, India
| | - N A Fouzia
- Department of Clinical Hematology, Christian Medical College, Vellore, India
| | | | | | | | - Aparna Dhondi Dalvi
- Indian Council of Medical Research-National Institute of Immunohematology, Mumbai, India
| | - Reetika Malik Yadav
- Indian Council of Medical Research-National Institute of Immunohematology, Mumbai, India
| | - Umair Ahmed Bargir
- Indian Council of Medical Research-National Institute of Immunohematology, Mumbai, India
| | - Priyanka Madhav Kambli
- Indian Council of Medical Research-National Institute of Immunohematology, Mumbai, India
| | - Amit Rawat
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jhumki Das
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vibhu Joshi
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Pilania
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Kumar Jindal
- Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Bhat
- Mazumdar Shaw Cancer Centre, Narayana Health City, Bengaluru, India
| | | | | | | | | | | | | | | | - Amita Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | | | - Anne Puel
- University of Paris, Institute Imagine, INSERM, Paris, France.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States
| | - Jacinta Bustamante
- University of Paris, Institute Imagine, INSERM, Paris, France.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States.,Study Center for Immunodeficiencies, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Jean Laurent Casanova
- University of Paris, Institute Imagine, INSERM, Paris, France.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States.,Howard Hughes Medical Institute, New York, NY, United States
| | - Mukesh M Desai
- Department of Immunology, B. J. Wadia Hospital for Children, Mumbai, India
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