Mutations in PIK3CD can cause hyper IgM syndrome (HIGM) associated with increased cancer susceptibility

J Clin Immunol. 2014 Apr;34(3):272-6. doi: 10.1007/s10875-014-0012-9. Epub 2014 Mar 8.

Abstract

Autosomal dominant gain of function mutations in the gene encoding PI3K p110δ were recently associated with a novel combined immune deficiency characterized by recurrent sinopulmonary infections, CD4 lymphopenia, reduced class-switched memory B cells, lymphadenopathy, CMV and/or EBV viremia and EBV-related lymphoma. A subset of affected patients also had elevated serum IgM. Here we describe three patients in two families who were diagnosed with HIGM at a young age and were recently found to carry heterozygous mutations in PIK3CD. These patients had an abnormal circulating B cell distribution featuring a preponderance of early transitional (T1) B cells and plasmablasts. When stimulated in vitro, PIK3CD mutated B cells were able to secrete class-switched immunoglobulins. This finding implies that the patients' elevated serum IgM levels were unlikely a product of an intrinsic B cell functional inability to class switch. All three patients developed malignant lymphoproliferative syndromes that were not associated with EBV. Thus, we identified a novel subset of patients with PIK3CD mutations associated with HIGM, despite indications of preserved in vitro B cell class switch recombination, as well as susceptibility to non-EBV-associated malignancies.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Biopsy
  • Child
  • Class I Phosphatidylinositol 3-Kinases / genetics*
  • Female
  • Genetic Predisposition to Disease*
  • Heterozygote
  • Humans
  • Hyper-IgM Immunodeficiency Syndrome / complications*
  • Hyper-IgM Immunodeficiency Syndrome / diagnosis
  • Hyper-IgM Immunodeficiency Syndrome / genetics*
  • Lymph Nodes / pathology
  • Male
  • Mutation*
  • Neoplasms / diagnosis
  • Neoplasms / etiology*
  • Pedigree
  • Young Adult

Substances

  • Class I Phosphatidylinositol 3-Kinases
  • PIK3CD protein, human