Thomas Sanya, Guenther Geoffrey, Rowe Jared H, Platt Craig D, Shimamura Akiko, Levy Ofer, Ganapathi Lakshmi
Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Pediatr. 2023 Jul 17;11:1223191. doi: 10.3389/fped.2023.1223191. eCollection 2023.
Severe congenital neutropenia caused by jagunal homolog 1 () mutation is a rare condition resulting from maturation arrest secondary to endoplasmic reticulum stress response from impaired neutrophil protein glycosylation. Here, we report a case of a 4-year-old boy who presented with a history of recurrent infections and manifestations, including recurrent intracranial hemorrhage. A review of similar cases reported in the literature indicates that a bleeding diathesis has not been previously described in these patients. We hypothesize that this newly described association of bleeding complications in this patient with mutation is secondary to defective glycosylation in the normal functioning of platelets or clotting factors. Recurrent infections with intracranial hemorrhage, new focal neurologic defects, or altered mental status in a child should warrant a suspicion for this immunodeficiency for the prompt initiation of treatment and prophylaxis for life-threatening infections or trauma.
由 jagunal 同源物 1()突变引起的严重先天性中性粒细胞减少症是一种罕见病症,它是由于中性粒细胞蛋白质糖基化受损引发内质网应激反应导致成熟停滞所致。在此,我们报告一例 4 岁男孩病例,该男孩有反复感染病史及包括反复颅内出血在内的临床表现。对文献中报道的类似病例回顾显示,此前这些患者中尚未描述有出血倾向。我们推测,该患者中这种新描述的出血并发症与 突变之间的关联是血小板或凝血因子正常功能中糖基化缺陷所致。儿童出现反复感染伴颅内出血、新的局灶性神经功能缺损或精神状态改变时,应怀疑存在这种免疫缺陷,以便及时开始治疗并预防危及生命的感染或创伤。