Abstract This research investigated the clinical features of immunodeficiency disease and the features of the mutation of its pathogenic genes. All 7 patients were boys aged 5 months to 4 years and 6 months and had a history of recurrent respiratory infection and pneumonia, low levels of IgM and IgG, and abnormal absolute values or percentages of lymphocyte subsets. High-throughput sequencing showed c.1684C > T mutations in the BTK gene in patient 1 and IVS8+2T > C splice site mutations in the BTK gene in patient 2. Both of these mutations came from their mothers. Patients 3, 4, and 5 had mutations in the IL2RG gene, i.e., c.298C > T, IVS3-2A > G, and c.164T > A, among which c.164T > A mutations had not been reported. Patient 6 had c.204C > G mutations in the RAG2 gene. Patient 7 had complex heterozygous mutations of c.913C > T and c.824G > A in the RAG2 gene, which came from his father and mother, respectively. Patients with immunodeficiency disease have abnormal immunological indices, and high-throughput sequencing helps to make a definite diagnosis.
WANG Jun-Chao,LIU Xiao-Xue. Clinical features and gene mutations of primary immunodeficiency disease: an analysis of 7 cases[J]. CJCP, 2018, 20(4): 285-289.
WANG Jun-Chao,LIU Xiao-Xue. Clinical features and gene mutations of primary immunodeficiency disease: an analysis of 7 cases[J]. CJCP, 2018, 20(4): 285-289.
Geha RS, Notarangelo LD, Casanova JL, et al. Primary immunodeficiency diseases:an update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee[J]. J Allergy Clin Immunol, 2007, 120(4):776-794.
[2]
Kohn DB, Kuo CY. New frontiers in the therapy of primary immunodeficiency:from gene addition to gene editing[J]. J Allergy Clin Immunol, 2017, 139(3):726-732.
[3]
Picard C, Al-Herz W, Bousfiha A, et al. Primary immunodeficiency diseases:an update on the classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency 2015[J]. J Clin Immunol, 2015, 35(8):696-726.
Tsukada S, Saffran DC, Rawlings DJ, et al. Deficient expression of a B cell cytoplasmic tyrosine kinase in human X-linked agammaglobulinemia[J]. J Immunol, 2012, 188(7):2936-2947.
[10]
Chen XF, Wang WF, Zhang YD, et al. Clinical characteristics and genetic profiles of 174 patients with X-linked agammaglobulinemia:Report from Shanghai, China (2000-2015)[J]. Medicine, 2016, 95(32):e4544.
[11]
Michos A, Tzanoudaki M, Villa A, et al. Severe combined immunodeficiency in Greek children over a 20 year period:rarity of γ-chain deficiency (X-linked) type[J]. J Clin Immunol, 2011, 31(5):778-783.
[12]
Buckley RH. Molecular defects in human severe combined immunodeficiency and approaches to immune reconstitution[J]. Annu Rev Immunol, 2004, 22:625-655.
[13]
Mukherjee S, Thrasher AJ. Gene therapy for PIDs:progress, pitfalls and prospects[J]. Gene, 2013, 525(2):174-181.
[14]
Myers LA, Patel DD, Puck JM, et al. Hematopoietic stem cell transplanation for severe combined immunodeficiency in the neonatal period leads to superior thymic output and improved survival[J]. Blood, 2002, 99(3):872-878.
[15]
Bai XM, Liu J, Zhang Z, et al. Clinical, immunologic, and genetic characteristics of RAG mutations in 15 Chinese patients with SCID and Omenn syndrome[J]. Immunol Res, 2016, 64(2):497-507.
[16]
Kato M, Kimura H, Seki M, et al. Omenn syndrome-review of several phenotypes of Omenn syndrome and RAG1/RAG2 mutations in Japan[J]. Allergol Int, 2006, 55(2):115-119.