›› 2018, Vol. 36 ›› Issue (3): 202-.doi: 10.3969/j.issn.1000-3606.2018.03.010

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Diagnosis and treatment of atypical severe combined immunodeficiency disease in 7 children

 HE Jianxin, CHEN Lanqin, ZHAO Yuhong, JIA Xinlei, LIU Gang, XU Baoping, LIU Xiuyun, GUI Jingang, SHEN Kunling, JIANG Zaifang   

  1. Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing 100045, China)
  • Received:2018-03-15 Online:2018-03-15 Published:2018-03-15

Abstract:  Objective To explore the diagnosis and treatment of atypical severe combined immunodeficiency disease (SCID). Methods The clinical data of atypical SCID in 7 children with IL2RG, JAK3, and RAG1 mutations were reviewed and analyzed from September 2012 to June 2017. Results In 7 cases (6 males and 1 female), there were 5 infants, 1 toddler and 1 school-age child. Cases 2, 4, and 6 were classic SCID clinical phenotypes. Cases 1, 3, 5, 7 were atypical SCID clinical phenotypes. Case 6 were diagnosed with Omenn syndrome. Cases 2, 5 were classic SCID immune phenotypes, cases 1, 3, 4, 6, 7 were atypical SCID immune phenotypes, and case 1 had maternal chimera. The next generation sequencing indicated that case 1 had a compound heterozygous JAK3 mutation with c.3097-1G>A/ c.946-950GCGGA>ACinsGGT. Cases 2, 3, and 4 had IL2RG mutations, with c. 865C>T/ p.R289X, c.664C>T/R222C, 52delG, respectively. Case 5 had JAK3 mutations with c.2150A>G/p.E717G and c.1915-2A>G. Sanger sequencing indicated that case 6 had a RAG1 mutation of complex heterozygosity with c.994C>T/p.R332X and c.1439G>A/p.S480N. Case 7 had homozygous RAG1 mutation with c.2095C>T/p.R699W. Conclusion Under certain conditions, gene mutation can lead to atypical clinical and/or immune phenotypic SCID.