IL2RG reversion event in a common lymphoid progenitor leads to delayed diagnosis and milder phenotype

J Clin Immunol. 2015 Jul;35(5):449-53. doi: 10.1007/s10875-015-0174-0. Epub 2015 Jun 17.

Abstract

Severe combined immunodeficiency (SCID) is most frequently caused by mutations in the cytokine receptor common gamma chain, CD132, encoded by the X-linked gene, IL2RG. Most patients present in the first year of life with failure to thrive, severe, opportunistic infections and absence of CD3+ T cells. We present a patient with pediatric illness and a diagnosis of combined variable immune deficiency (CVID) who was diagnosed at age 23 with an inherited IL2RG mutation causing loss of signal transduction through CD132. His peripheral blood included CD3/CD4 and CD3/CD8 positive cells as well as low levels of CD19+ B cells containing a reversion to the wildtype IL2RG allele. The reversion, which was not present at birth, may account for his mild phenotype and late diagnosis.

Publication types

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

MeSH terms

  • Adult
  • Antigens, CD19 / metabolism
  • B-Lymphocytes / physiology*
  • Bronchiectasis / diagnosis*
  • Bronchiectasis / genetics
  • CD4-Positive T-Lymphocytes / physiology*
  • CD8-Positive T-Lymphocytes / physiology*
  • Delayed Diagnosis
  • Humans
  • Infant, Newborn
  • Infections / diagnosis*
  • Infections / genetics
  • Interleukin Receptor Common gamma Subunit / genetics*
  • Lymphoid Progenitor Cells / physiology*
  • Male
  • Mutation / genetics
  • Pedigree
  • Phenotype
  • Severe Combined Immunodeficiency / diagnosis*
  • Severe Combined Immunodeficiency / genetics
  • Signal Transduction / genetics
  • Skin / pathology*
  • Young Adult

Substances

  • Antigens, CD19
  • Interleukin Receptor Common gamma Subunit