Abstract
Genetic mutations that result in loss-of-function of the protein A20 result in an early-onset autoinflammatory disease-haploinsufficiency of A20 (HA20). The reported clinical presentations of HA20 include a Behcet's disease-like phenotype and a more lupus-like phenotype. We have identified a novel mutation in the gene encoding A20 in a pediatric patient with chronic lymphadenopathy, lupus-like symptoms, and progressive hypogammaglobulinemia. This case illustrates the wide range of clinical symptoms, including immunodeficiency, that can occur in patients with HA20.
Keywords:
A20; case report; haploinsufficiency of A20; hypogammaglobulinemia; lupus; lymphadenopathy; tumor necrosis factor alpha-induced protein 3.
Copyright © 2021 Shaheen, Williams and Binstadt.
MeSH terms
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Adolescent
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Agammaglobulinemia / diagnosis
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Agammaglobulinemia / drug therapy
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Agammaglobulinemia / genetics*
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Agammaglobulinemia / immunology
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DNA Mutational Analysis
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Diagnosis, Differential
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Female
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Genetic Predisposition to Disease
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Glucocorticoids / therapeutic use
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Haploinsufficiency*
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Hereditary Autoinflammatory Diseases / diagnosis
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Hereditary Autoinflammatory Diseases / drug therapy
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Hereditary Autoinflammatory Diseases / genetics*
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Hereditary Autoinflammatory Diseases / immunology
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Heredity
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Humans
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Immunosuppressive Agents / therapeutic use
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Loss of Function Mutation*
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Lupus Erythematosus, Systemic / diagnosis
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Lupus Erythematosus, Systemic / genetics*
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Lupus Erythematosus, Systemic / immunology
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Lymphadenopathy / diagnosis
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Lymphadenopathy / drug therapy
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Lymphadenopathy / genetics*
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Lymphadenopathy / immunology
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Pedigree
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Phenotype
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Predictive Value of Tests
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Treatment Outcome
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Tumor Necrosis Factor alpha-Induced Protein 3 / genetics*
Substances
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Glucocorticoids
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Immunosuppressive Agents
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TNFAIP3 protein, human
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Tumor Necrosis Factor alpha-Induced Protein 3