Table 1.
Feature1 | New Patient P7 (this report) | Previous published reports | Common findings | ||
---|---|---|---|---|---|
P1 [5,6] | P2, P3, P4 [7] | P5, P6 [18,19] | |||
Age at immune evaluation, sex | 14 mo F | 15 mo F | P2, 12 mo M; P3, 7.5 mo F; P4, 14 mo F | P5, 7 yr F; P6, 7 yr M | CID, onset of infections in infancy |
Genotype | R12L/del16p11 | c248delCT/del16p11 | V134M/V134M | c248delCT/Q360RfsX44 | Interstitial del 16p11; recessive variants |
Outcome | Died of lymphoma prior to HCT2 | Alive and well after HCT | P2 alive, no HCT; P3 died prior to HCT; P4 died with HCT | P5 died with HCT; P6 alive, HCT planned | HCT can cure otherwise lethal infections and organ damage |
Immunoglobulins (mg/dL) | |||||
IgG (762±209) | 50 | NA3 (on IVIG) | Normal | Normal | Low - normal |
IgM (58±23) | 151 | 46 | Normal | P5 low; P6 normal | Low - normal |
IgA (50±24) | 60 | 42 | Normal | P5 low; P6 normal | Low - normal |
Lymphocyte subsets (cells/uL) | |||||
CD3 T (2100–6200) | 98 | 110 | Low | Low | Low |
CD4 T (1300–3400) | 39 | 50 | Low | Low | Low |
CD8 T (620–2000) | 49 | 30 | Low | Low | Low |
CD45RA T | Nearly absent | Low | Low | Very low | Low |
CD45RO T (<65%) | 90% | NA | 98% | NA | High |
TRECs at diagnosis (>33/μl) | 2 (normal PCR control) | NA | NA | NA | Low |
CD19 B (300–2600) | 59 | 410 | Low | Low | Low - normal |
CD16/56 NK (>200) | 121 | 340 | Normal | Low | Low - normal |
NK cell function | Normal | NA | NA | Low | Low - normal |
Mitogen response (% of normal) | |||||
PHA | <10% | 10–30% | Low-normal | Low | Low - normal |
PWM | <10% | <10% | NA | Low - normal | Low - normal |
ConA | <10% | <10% | NA | Low | Low |
Antibody production after vaccination | |||||
Tetanus (>0.15 IU/ml) | 1.65 | 0.02 | Normal | Normal | Poor specific antibody responses |
H. influenzae B (>1.0 IU/ml) | NA | 0.7 | <1.0 | NA | |
S pneumoniae (serotypes protective) | 0 post 13-valent conjugate vaccine | NA | P2, P3 NA; P4 normal | Low - normal | |
Other studies | |||||
Epstein-Barr virus | >25,000 copies; EBV+B cell lymphoma at 14 mo | NA | P4, EBV+ B cell lymphoproliferation, lymphoma at 12 mo | P5, stage IV Hodgkin lymphoma and diffuse large B cell lymphoma, both EBV+ | Severe EBV infections, early onset EBV+ lymphoma |
TCR Vβ | High CD8 Vβ5.1 | NA | P2, high Vβ4; P2 and P4, low TCR diversity | Abnormal TCR | Limited TCR diversity |
Normal ranges for ages 12–24 months in parentheses.
HCT, hematopoietic cell transplant.
NA, not available