De novo mutation in the BTK gene of atypical X-linked agammaglobulinemia in a patient with recurrent pyoderma.

BACKGROUND: X-linked agammaglobulinemia (XLA), characterized by a profound deficiency of all immunoglobulins and the absence of mature B cells, is caused by mutations in the gene encoding Bruton tyrosine kinase (BTK). Most patients have recurrent sinopulmonary infection. Infections usually occur in...

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Publicado en:Annals of Allergy, Asthma & Immunology Vol. 96; no. 5; pp. 744 - 749
Autores principales: Lin MT, Chien YH, Shyur SD, Huang LH, Chiang YC, Wen DC, Liang PH, Yang HC
Formato: case study Journal Article
Publicado: Elsevier B.V. 2006 May
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2006 May
      vid: 96
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      pub: Elsevier B.V.
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        atl: De novo mutation in the BTK gene of atypical X-linked agammaglobulinemia in a patient with recurrent pyoderma.
      aug:
        au:
          Lin MT
          Chien YH
          Shyur SD
          Huang LH
          Chiang YC
          Wen DC
          Liang PH
          Yang HC
      sug:
        subj:
          Agammaglobulinemia Immunology
          Genetic Diseases, X-Linked Immunology
          Mutation
          Pyoderma Etiology
          Transferases
          Adolescence
          Adult
          Agammaglobulinemia Complications
          Agammaglobulinemia
          B Lymphocytes Immunology
          Child
          Diagnosis, Differential
          Flow Cytometry
          Genetic Diseases, X-Linked Complications
          Genetic Diseases, X-Linked
          Immunologic Deficiency Syndromes Pathology
          Male
          Nucleotides
          Pedigree
          Polymerase Chain Reaction
          Recurrence
          Sequence Analysis
          Adolescent: 13-18 years
          Adult: 19-44 years
          Child: 6-12 years
          Male
      ab: BACKGROUND: X-linked agammaglobulinemia (XLA), characterized by a profound deficiency of all immunoglobulins and the absence of mature B cells, is caused by mutations in the gene encoding Bruton tyrosine kinase (BTK). Most patients have recurrent sinopulmonary infection. Infections usually occur in multiple locations across time, but single infection may be limited to one anatomic location. OBJECTIVES: To report a case of atypical XLA with recurrent pyoderma and to observe the immunologic changes in the patient in 10 years. METHODS: Immunologic investigations, skin wound culture, and molecular study with DNA sequencing were performed. RESULTS: The patient was originally diagnosed as having common variable immunodeficiency disease because of the presence of circulating B cells (CD19+ B cells: 7%) at 11 years old. On further evaluation at the age of 20 years, flow cytometric analysis of lymphocytes showed only 0.4% B cells. The molecular study with DNA sequencing of the patient showed a point mutation in complementary DNA 1630 A>G(p.R544G) in the BTK gene, indicating that the patient has XLA. The mutation analysis of the BTK gene revealed a normal DNA sequence in the other family members. CONCLUSIONS: This case is an important example of a possible presentation of XLA with a predominant skin manifestation, and it demonstrates that maintaining a high level of clinical suspicion is essential for the diagnosis of XLA in a child with recurrent pyoderma.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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