From the Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi Med J. 2024 Aug;45(8):851-856. doi: 10.15537/smj.2024.45.8.20240123.
Autosomal dominant hyper immunoglobulin E (IgE) syndrome is a rare inborn error of immunity that affects approximately one in a million individuals worldwide. It presents with various symptoms owing to multisystem involvement (immunological and non-immunological). Recurrent infections (mainly in the skin and lungs) are common presentations. A 5-year-old Middle Eastern boy presented with symptoms suggestive of obstructive uropathy secondary to multiple large pelviabdominal abscesses and acute kidney injury with hyperkalemia that necessitated admission to the intensive care unit. Upon further investigation, the patient's genetic test (whole exome sequencing) demonstrated a heterozygous missense variant in the STAT3 gene. The patient completely recovered and did not require further admission after initiating prophylactic antibiotics. Although deep-seated infections are uncommon in STAT3 hyper IgE syndrome, skin and lung infections are most commonly observed. Multiple deep collections can occur and require prompt intervention and aggressive treatment.
常染色体显性遗传高免疫球蛋白 E(IgE)综合征是一种罕见的先天性免疫缺陷病,全球每百万人中约有 1 人患病。它因多系统受累(免疫和非免疫)而表现出各种症状。复发性感染(主要发生在皮肤和肺部)是常见的表现。一名 5 岁的中东男孩因多发性大骨盆腹脓肿和高钾血症引起的阻塞性尿路病导致急性肾损伤而需要入住重症监护病房,出现了疑似阻塞性尿路病的症状。进一步检查显示,患者的基因检测(外显子组测序)显示 STAT3 基因存在杂合错义变异。患者在开始预防性使用抗生素后完全康复,无需进一步住院治疗。尽管 STAT3 高免疫球蛋白 E 综合征中深部感染并不常见,但最常观察到皮肤和肺部感染。可能会出现多个深部积液,需要及时干预和积极治疗。