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一名C6联合突变的HIV阴性患者的复发性机会性感染:病例报告、系谱分析及文献综述

Recurrent opportunistic infections in a HIV-negative patient with combined C6 and mutations: A case report, pedigree analysis, and literature review.

作者信息

Zheng Yamei, Guan Liwen, Li Jiao, Fu Yihui

机构信息

Department of Pulmonary and Critical Care Medicine, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China.

Department of Gastroenterology, Sanya Central Hospital (Hainan Third People's Hospital), Sanya, Hainan, China.

出版信息

Open Med (Wars). 2024 Dec 31;19(1):20241019. doi: 10.1515/med-2024-1019. eCollection 2024.

Abstract

INTRODUCTION

Recurrent opportunistic infections are particularly common in patients infected with human immunodeficiency virus (HIV). However, these opportunistic infections have also been reported in HIV-negative patients, especially those with primary immunodeficiency disorder (PID), a condition that involves a large heterogeneous group of disorders arising from defects in immune system development and/or function.

CASE

Here, we report a very rare case of recurrent opportunistic infections in a non-HIV-infected patient combined with mutations in complement component C6 and nuclear factor kB subunit 1 (). The patient first developed pneumonia, followed by cytomegalovirus esophagitis. Reduced CD4+ T and B lymphocyte counts, hypogammaglobulinemia were observed. The patient was HIV negative, and congenital immunodeficiency-related genes indicated combined C6 and mutations. Gene detection was undertaken with blood samples from the patient's parents and younger brother. None of the family members possessed both gene mutations, suggesting that the simultaneous mutations of C6 and caused primary immunodeficiency in the patient and resulted in recurrent opportunistic infections. In addition, we performed a review of the relevant literature to assess the clinical manifestations of C6 and mutations.

CONCLUSION

A diagnosis of PID should be suspected in patients with recurrent opportunistic infections, decreased CD4+ T and B lymphocyte, and hypoimmunoglobulinemia when secondary immunodeficiency factors can be excluded. In addition, genetic testing of family members should be performed, which may lead to the discovery of novel familial gene mutations.

摘要

引言

复发性机会性感染在感染人类免疫缺陷病毒(HIV)的患者中尤为常见。然而,这些机会性感染在HIV阴性患者中也有报道,特别是那些患有原发性免疫缺陷病(PID)的患者,这是一种由免疫系统发育和/或功能缺陷引起的一大类异质性疾病。

病例

在此,我们报告一例非常罕见的非HIV感染患者复发性机会性感染合并补体成分C6和核因子κB亚基1()突变的病例。该患者首先出现肺炎,随后是巨细胞病毒食管炎。观察到CD4 + T和B淋巴细胞计数减少、低丙种球蛋白血症。患者HIV阴性,先天性免疫缺陷相关基因检测显示C6和均有突变。对患者父母和弟弟的血液样本进行了基因检测。家庭成员均无这两种基因突变,提示C6和同时突变导致患者原发性免疫缺陷并引发复发性机会性感染。此外,我们对相关文献进行了综述,以评估C6和突变的临床表现。

结论

当排除继发性免疫缺陷因素时,对于复发性机会性感染、CD4 + T和B淋巴细胞减少以及免疫球蛋白血症低下的患者,应怀疑患有PID。此外,应进行家庭成员的基因检测,这可能会发现新的家族基因突变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b775/11737363/45f62f7a1bf5/j_med-2024-1019-fig001.jpg

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