Different clinical phenotypes in familial severe congenital neutropenia cases with same mutation of the ELANE gene

J Korean Med Sci. 2014 Mar;29(3):452-5. doi: 10.3346/jkms.2014.29.3.452. Epub 2014 Feb 27.

Abstract

Severe congenital neutropenia (SCN) is a heterogeneous group of disorders with a defect in granulopoiesis causing marked neutropenia and severe bacterial infections. A 17-month-old girl (patient 1) was admitted due to cervical lymphadenitis caused by methicillin-resistant Staphylococcus aureus, with neutropenia. She had Pseudomonas aeruginosa sepsis and peritonitis with perforated appendicitis at 8-month of age. Her sister, a 37-month-old girl (patient 2), had recurrent stomatitis with profound neutropenia, and her mother, a 32-yr-old woman (patient 3), had had recurrent stomatitis until her early 20s with neutropenia. We found an ELANE gene mutation (c.597+1G > A) from them in direct DNA sequencing analysis. Patients 1 and 2 did not respond to granulocyte colony stimulating factor and patient 1 was treated with prolonged antibiotics and excision. We demonstrated inherited SCN cases showing different severity even with the same mutation of the ELANE gene in a family.

Keywords: Infection; Neutrophil Elastase; Severe Congenital Neutropenia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Child, Preschool
  • Congenital Bone Marrow Failure Syndromes
  • DNA Mutational Analysis
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Infant
  • Leukocyte Elastase / genetics*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Mutation / genetics
  • Neutropenia / congenital*
  • Neutropenia / diagnosis
  • Neutropenia / drug therapy
  • Neutropenia / genetics
  • Pedigree
  • Phenotype*
  • Polymorphism, Single Nucleotide
  • Recurrence
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / microbiology
  • Stomatitis / diagnosis
  • Tomography, X-Ray Computed

Substances

  • Granulocyte Colony-Stimulating Factor
  • Leukocyte Elastase

Supplementary concepts

  • Neutropenia, Severe Congenital, Autosomal Recessive 3