Profound T-cell lymphopenia associated with prenatal exposure to purine antagonists detected by TREC newborn screening

J Allergy Clin Immunol Pract. 2017 Jan-Feb;5(1):198-200. doi: 10.1016/j.jaip.2016.09.028.

Abstract

Recognition of non-SCID and secondary causes of T cell lymphopenia detected by TREC newborn screening is important in directing subsequent care and identifying those who would not benefit from more invasive interventions. Here, we report two infants with low TRECs and severe, but self-resolving, T cell lymphopenia identified by SCID NBS that were caused by in utero exposure to purine antimetabolites.

Publication types

  • Case Reports

MeSH terms

  • Aza Compounds / adverse effects*
  • Aza Compounds / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Infant, Newborn
  • Lymphocyte Count
  • Lymphopenia / diagnosis*
  • Lymphopenia / genetics
  • Lymphopoiesis / drug effects
  • Male
  • Mercaptopurine / adverse effects*
  • Mercaptopurine / therapeutic use
  • Neonatal Screening
  • Pathology, Molecular
  • Pregnancy
  • Prenatal Exposure Delayed Effects / diagnosis*
  • Purines / antagonists & inhibitors*
  • Receptors, Antigen, T-Cell / genetics*
  • Severe Combined Immunodeficiency / diagnosis*
  • T-Lymphocytes / physiology*
  • United States

Substances

  • Aza Compounds
  • Immunosuppressive Agents
  • Purines
  • Receptors, Antigen, T-Cell
  • Mercaptopurine
  • purine