1
|
Chandola S, Prabhakar P, Seth R, Jana M. Intramural Duodenal Hematoma in a Case of Hyper IgM Syndrome. J Pediatr Hematol Oncol 2024; 46:104-105. [PMID: 37867238 DOI: 10.1097/mph.0000000000002773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/17/2023] [Indexed: 10/24/2023]
Abstract
Three-year-old boy who presented with colicky abdominal pain, diarrhoea and vomiting was investigated with computed tomography which revealed a mass in the peripancreatic region. An imaging possibility of duodenal intramural hematoma was considered after reassessment with ultrasound which was subsequently confirmed by magnetic resonance imaging. The development of a spontaneous duodenal hematoma lead to further evaluation of the patient and revealed X linked hyper IgM syndrome.
Collapse
Affiliation(s)
- Stuti Chandola
- Department of Radiodiagnosis and Interventional Radiology
| | | | - Rachna Seth
- Department of Pediatric Oncology, AIIMS, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis and Interventional Radiology
| |
Collapse
|
2
|
Yang L, Chen L, Xie L, Xiong Y, Liu H. Late diagnosis of X-linked hyper-IgM syndrome presenting as community-acquired Pseudomonas aeruginosa pneumonia-related septic shock. Pediatr Pulmonol 2023; 58:3403-3405. [PMID: 37830525 DOI: 10.1002/ppul.26672] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/10/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Lin Yang
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lina Chen
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Liang Xie
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying Xiong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
| | - Hanmin Liu
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
- Sichuan Birth Defects Clinical Research Center, West China Second University Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Pazhanisamy A, Jorge SD, Zimmermann MT, Kitcharoensakkul M, Abdalgani M, Khojah A, Victor C, Rueda C, Urrutia R, Abraham RS. Advanced computational analysis of CD40LG variants in atypical X-linked hyper-IgM syndrome. Clin Immunol 2023; 253:109692. [PMID: 37433422 DOI: 10.1016/j.clim.2023.109692] [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] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/31/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
X-Linked Hyper-IgM Syndrome is caused by pathogenic variants in CD40LG. Three patients with atypical clinical and immunological features were identified with variants in CD40LG requiring further characterization. Flow cytometry was used to evaluate CD40L protein expression and binding capacity to a surrogate receptor, CD40-muIg. Though functional anomalies were observed, there was still a lack of clarity regarding the underlying mechanism. We developed structural models for wild-type and the three variants of CD40L protein observed in these patients (p. Lys143Asn, Leu225Ser and Met36Arg) to evaluate structural alterations by molecular mechanic calculations, and assess protein movement by molecular dynamic simulations. These studies demonstrate that functional analysis of variants of unknown significance in CD40LG can be supplemented by advanced computational analysis in atypical clinical contexts. These studies in combination identify the deleterious effects of these variants and potential mechanisms for protein dysfunction.
Collapse
Affiliation(s)
- Amudha Pazhanisamy
- Department of Pediatrics, Nationwide Children's Hospital, OH, USA; The Ohio State University Wexner Medical Center, OH, USA
| | | | | | - Maleewan Kitcharoensakkul
- Division of Rheumatology/Immunology, Department of Pediatrics, Washington University in St. Louis, MO, USA
| | | | - Amer Khojah
- Department of Pediatrics, Umm Al-Qura University, Saudi Arabia
| | - Christian Victor
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, OH, USA
| | - Cesar Rueda
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, OH, USA
| | | | - Roshini S Abraham
- The Ohio State University Wexner Medical Center, OH, USA; Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, OH, USA.
| |
Collapse
|
4
|
Kacar M, Shrimpton JK, Jassam M, Mistry A, Arumugakani G, Grammatikos A, Gompels M, Doody GM, Savic S. Hyper-IgM syndrome resulting from heterozygous AICDA variants: A European first? Scand J Immunol 2022; 96:e13155. [PMID: 35271747 DOI: 10.1111/sji.13155] [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] [Indexed: 12/01/2022]
Affiliation(s)
- Mark Kacar
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK
| | - Jennifer K Shrimpton
- Section of Experimental Haematology, Leeds Institute of Medical Research, St. James's University Hospital, University of Leeds, Leeds, UK
| | - Miriam Jassam
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK
| | - Anoop Mistry
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK
| | - Gururaj Arumugakani
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK
| | | | - Mark Gompels
- Department of Immunology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Gina M Doody
- Section of Experimental Haematology, Leeds Institute of Medical Research, St. James's University Hospital, University of Leeds, Leeds, UK
| | - Sinisa Savic
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK
- Leeds Musculoskeletal Biomedical Research Centre, National Institute for Health Research, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
| |
Collapse
|
5
|
王 子, 孟 岩, 窦 颖, 管 贤, 张 璐, 于 洁. [Clinical effect of allogeneic hematopoietic stem cell transplantation in children with hyper-IgM syndrome]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:635-642. [PMID: 35762429 PMCID: PMC9250404 DOI: 10.7499/j.issn.1008-8830.2112098] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To evaluate the clinical effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with hyper-IgM syndrome (HIGM). METHODS A retrospective analysis was performed on the medical data of 17 children with HIGM who received allo-HSCT. The Kaplan Meier method was used for the survival analysis of the children with HIGM after allo-HSCT. RESULTS After allo-HSCT, 16 children were diagnosed with sepsis; 14 tested positive for virus within 100 days after allo-HSCT, among whom 11 were positive for Epstein-Barr virus, 7 were positive for cytomegalovirus, and 2 were positive for JC virus; 9 children were found to have invasive fungal disease. There were 6 children with acute graft-versus-host disease and 3 children with chronic graft-versus-host disease. The median follow-up time was about 2 years, and 3 children died in the early stage after allo-HSCT. The children had an overall survival (OS) rate of 82.35%, an event-free survival (EFS) rate of 70.59%, and a disease-free survival (DFS) rate of 76.47%. The univariate analysis showed that the children receiving HLA-matched allo-HSCT had a significantly higher EFS rate than those receiving HLA-mismatched allo-HSCT (P=0.019) and that the children receiving HLA-matched unrelated allo-HSCT had significantly higher OS, EFS, and DFS rates than those receiving HLA-mismatched unrelated allo-HSCT (P<0.05). Compared with the children with fungal infection after allo-HSCT, the children without fungal infection had significantly higher EFS rate (P=0.02) and DFS rate (P=0.04). CONCLUSIONS Allo-HSCT is an effective treatment method for children with HIGM. HLA-matched allo-HSCT and active prevention and treatment of fungal infection and opportunistic infection may help to improve the prognosis of such children.
Collapse
|
6
|
Özdemir PG, Yazicioğlu M, Aylanç H, Ozkayin N. EBV-induced erythema multiforme: a case report. Allergol Immunopathol (Madr) 2011; 39:116-8. [PMID: 21458140 DOI: 10.1016/j.aller.2010.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Revised: 05/14/2010] [Accepted: 05/17/2010] [Indexed: 11/18/2022]
Affiliation(s)
- P Gökmirza Özdemir
- Department of Pediatric Allergy, Trakya University Faculty of Medicine, Edirne, Turkey.
| | | | | | | |
Collapse
|