Title |
Diagnosis of 22q11.2 Deletion Syndrome and Artemis Deficiency in Two Children with T-B-NK+ Immunodeficiency
|
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Published in |
Journal of Clinical Immunology, August 2012
|
DOI | 10.1007/s10875-012-9741-9 |
Pubmed ID | |
Authors |
Jennifer Heimall, Michael Keller, Rushani Saltzman, Nancy Bunin, Donna McDonald-McGinn, Elaine Zakai, Jean-Pierre de Villartay, Despina Moshous, Barbara Ariue, Elizabeth A. McCarthy, Blythe H. Devlin, Suhag Parikh, Rebecca H. Buckley, M. Louise Markert |
Abstract |
Two infants are described who presented with 22q11.2 deletion and a T(-)B(-)NK(+) immune phenotype. For both infants, the initial diagnosis was athymia secondary to complete DiGeorge anomaly. The first infant underwent thymus transplantation but 6 months after transplantation had circulating thymus donor T cells; the patient did not develop recipient naïve T cells. Genetic analyses revealed that both patients had Artemis deficiency, a rare form of severe combined immunodeficiency (SCID). Both infants have subsequently undergone bone marrow transplantation. These cases illustrate the importance and paradox of differentiating SCID from complete DiGeorge anomaly because hematopoietic stem cell transplantation (HSCT) is the preferred treatment for SCID but is ineffective for complete DiGeorge anomaly. However, if the thymus is completely absent, donor stem cells from a HSCT would not be able to be educated. |
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