Successful allogeneic hemopoietic stem cell transplantation in a child who had anhidrotic ectodermal dysplasia with immunodeficiency

Pediatrics. 2006 Jul;118(1):e205-11. doi: 10.1542/peds.2005-2661. Epub 2006 Jun 12.

Abstract

Anhidrotic ectodermal dysplasia with immunodeficiency is associated with multiple infections and a poor clinical outcome. Hypomorphic mutations in nuclear factor kappaB essential modulator (NEMO)/IkappaB kinase complex and a hypermorphic mutation in inhibitor alpha of nuclear factor kappaB (IkappaBalpha) both result in impaired nuclear factor kappaB activation and are associated with X-recessive and autosomal-dominant forms of anhidrotic ectodermal dysplasia with immunodeficiency, respectively. Autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency is also associated with a severe T-cell phenotype. It is not known whether hematopoietic stem cell transplantation can cure immune deficiency in children with anhidrotic ectodermal dysplasia with immunodeficiency. A boy with autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency and a severe T-cell immunodeficiency underwent transplantation at 1 year of age with haploidentical T-cell-depleted bone marrow after myeloablative conditioning. Engraftment occurred, with full hematopoietic chimerism. Seven years after transplantation, clinical outcome is favorable, with normal T-cell development. As expected, the developmental features of the anhidrotic ectodermal dysplasia syndrome have appeared and persisted. This is the first report of successful hematopoietic stem cell transplantation in a child with anhidrotic ectodermal dysplasia with immunodeficiency. Hematopoietic stem cell transplantation is well tolerated and efficiently cures the profound immunodeficiency associated with autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency.

Publication types

  • Case Reports

MeSH terms

  • Chimerism
  • Comorbidity
  • Ectodermal Dysplasia / epidemiology*
  • Ectodermal Dysplasia / immunology
  • Ectodermal Dysplasia / therapy*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Deficiency Syndromes / epidemiology*
  • Immunologic Deficiency Syndromes / immunology
  • Immunologic Deficiency Syndromes / therapy*
  • Infant, Newborn
  • Lymphocyte Count
  • Male
  • Recurrence
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / immunology
  • T-Lymphocytes / immunology
  • Transplantation Conditioning
  • Warts / epidemiology
  • Warts / immunology

Substances

  • Immunoglobulins, Intravenous