Distinct clinical phenotype and immunoreactivity in Japanese siblings with autoimmune polyglandular syndrome type 1 (APS-1) associated with compound heterozygous novel AIRE gene mutations

Clin Immunol. 2002 Jun;103(3 Pt 1):277-83. doi: 10.1006/clim.2002.5208.

Abstract

We herein report on two Japanese siblings with autoimmune polyglandular syndrome type 1 (APS-1). The brother, who expressed a characteristic phenotype of APS-1, had developed severe mucocutaneous candidiasis in early infancy and thereafter developed hypoparathyroidism and Addison's disease, along with a severe deterioration of his immunologic function. In contrast, the 44-year-old sister, who showed a noncharacteristic phenotype of APS-1, developed insulin-dependent diabetes with high anti-glutamic acid decarboxylase antibody, mild nail candidiasis, and autoimmune hepatitis with intact immunoreactivity. She had three susceptible human leukocyte antigen (HLA) loci for type 1 autoimmune diabetes. The expression of T cell receptor (TCR)V beta 5.1 increased in both patients, while the brother showed a widely suppressed expression of many TCRV beta families. Both individuals possessed compound heterozygous novel autoimmune regulator (AIRE) gene mutations (L29P and IVS9-1G > C). The same AIRE gene mutations can thus be associated with characteristic and noncharacteristic phenotypes of APS-1, and HLA may possibly influence the phenotype of APS-1.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIRE Protein
  • Addison Disease / genetics
  • Addison Disease / immunology
  • Addison Disease / pathology
  • Adult
  • Candidiasis, Chronic Mucocutaneous / genetics
  • Candidiasis, Chronic Mucocutaneous / immunology
  • Candidiasis, Chronic Mucocutaneous / pathology
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / pathology
  • Fatal Outcome
  • Female
  • Flow Cytometry
  • Humans
  • Japan
  • Lymphocyte Culture Test, Mixed
  • Male
  • Mutation* / genetics
  • Mutation* / immunology
  • Nuclear Family
  • Pedigree
  • Phenotype
  • Polyendocrinopathies, Autoimmune / genetics
  • Polyendocrinopathies, Autoimmune / immunology*
  • Polyendocrinopathies, Autoimmune / pathology
  • Polymerase Chain Reaction
  • Transcription Factors / genetics*
  • Transcription Factors / immunology

Substances

  • Transcription Factors