Early diagnosis of partial interferon-γ receptor 1 deficiency prevents the development of Bacille de Calmette et Guérin osteomyelitis

Clin Immunol. 2022 Feb:235:108933. doi: 10.1016/j.clim.2022.108933. Epub 2022 Jan 21.

Abstract

We encountered two patients with partial interferon γ receptor 1 (IFN-γR1) deficiency in whom early diagnosis enhanced disease management. Patient 1 was a 44-year-old woman with enlarged lymph nodes diagnosed in a pre-pregnancy checkup, and pathological examination revealed a Mycobacterium avium infection. Based on her history of unknown multiple osteomyelitis during early childhood, mendelian susceptibility to mycobacterial disease was suspected. Genetic analysis revealed a novel heterozygous variant in IFNGR1. Genetic counseling was administered to the patient and her husband before they had their baby. Patient 2 was a 4-month-old boy whose father was previously diagnosed with autosomal dominant IFN-γR1 deficiency owing to Bacille de Calmette et Guérin (BCG) osteomyelitis. Genetic analysis showed that he had the same INFGR1 variant. He avoided BCG vaccination and has been disease-free since then. Early diagnosis is considered to be useful for genetic counseling and essential for preventing BCG osteomyelitis.

Keywords: Bacille de Calmette et Guérin osteomyelitis; Partial interferon-γ receptor 1 deficiency.

MeSH terms

  • Adult
  • BCG Vaccine / adverse effects*
  • BCG Vaccine / immunology*
  • Female
  • Gene Deletion
  • Gene Expression Regulation
  • Humans
  • Infant
  • Interferon gamma Receptor
  • Male
  • Monocytes / metabolism
  • Mycobacterium bovis
  • Osteomyelitis / microbiology*
  • Pedigree
  • Receptors, Interferon / deficiency*
  • Receptors, Interferon / genetics*

Substances

  • BCG Vaccine
  • Receptors, Interferon