X-linked hyper-immunoglobulin M syndrome: Molecular genetic study and long-time follow-up of three generations of a Chinese family

Sheng-Chieh Lin, Shyh-Dar Shyur, Wen I. Lee, Yi-Chun Ma, Li-Hsin Huang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: X-linked hyper-immunoglobulin M (IgM) syndrome (XHIGM) is a rare immunodeficiency disease caused by mutations of the CD40 ligand gene. Patients are subject to recurrent infections and have normal or elevated levels of IgM but markedly decreased serum IgG. Objective: We describe molecular genetic studies and clinical manifestations in three generations of one family, as well as results of long-term treatment of 2 young men with the disorder. Methods: Of 37 living family members, mutational analysis of the CD40 ligand gene was performed in 36 members. Laboratory data for patients and carriers were reviewed. Results: Four male family members had died of unexplained causes. The 3 patients with XHIGM syndrome and the 5 carriers all had a novel mutation located at Tyr 169 Asn (T526A) in exon 5, the tumor necrosis factor domain of the CD40 ligand gene. In the 3 patients, CD40 ligand expression in activated CD4+ T cells was below 1%. In the carriers, about half of activated CD4+ cells expressed CD40 ligand. One carrier had malignant lymphoma. Long-term (>20 years) intravenous immunoglobulin therapy in 2 patients improved IgG levels but did not fully suppress the high levels of IgM, nor did it prevent late complications (bronchiectasis and sclerosing cholangitis). Conclusions: Diagnosis of a genetic immunodeficiency, especially an X-linked disease such as XHIGM syndrome, should prompt a survey of the entire family. Copyright © 2006 S. Karger AG.
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInternational Archives of Allergy and Immunology
Volume140
Issue number1
DOIs
Publication statusPublished - 2006
Externally publishedYes

Keywords

  • CD40 ligand gene
  • Intravenous immunoglobulin therapy
  • X-linked hyper-immunoglobulin M syndrome
  • asparagine
  • CD4 antigen
  • CD40 ligand
  • immunoglobulin
  • immunoglobulin G
  • immunoglobulin M
  • tumor necrosis factor
  • tyrosine
  • adult
  • antigen expression
  • bronchiectasis
  • cause of death
  • Chinese
  • clinical article
  • clinical feature
  • controlled study
  • exon
  • familial disease
  • female
  • follow up
  • genetic analysis
  • heterozygote
  • human
  • human cell
  • human tissue
  • hyperimmunoglobulinemia M
  • immune deficiency
  • immunoglobulin blood level
  • immunotherapy
  • infant
  • laboratory test
  • long term care
  • lymphocyte activation
  • lymphoma
  • male
  • medical record review
  • molecular genetics
  • mutagenesis
  • mutational analysis
  • priority journal
  • protein domain
  • review
  • sclerosing cholangitis
  • T lymphocyte
  • treatment duration
  • X chromosome linked disorder
  • Adolescent
  • Adult
  • Amino Acid Substitution
  • Asian Continental Ancestry Group
  • CD40 Ligand
  • Child
  • Child, Preschool
  • Common Variable Immunodeficiency
  • DNA Mutational Analysis
  • Female
  • Follow-Up Studies
  • Genetic Diseases, X-Linked
  • Heterozygote Detection
  • Humans
  • Immunoglobulin G
  • Immunoglobulin M
  • Infant
  • Male
  • Pedigree
  • Syndrome

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