GATA2 缺乏症并发全身疣病的临床表现和病程特点以及成年后骨髓增生异常综合征的结局

E. Frolov, F. I. Abdulaeva, U. A. Gornostaeva, T. Latysheva, E. Latysheva, G. E. Aminova
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引用次数: 0

摘要

GATA2 缺乏症是一种属于吞噬细胞先天缺陷的罕见疾病,临床表现为四种综合征:单核细胞、树突状细胞、B 淋巴细胞和 NK 淋巴细胞缺乏综合征;Emberger 综合征,包括原发性淋巴水肿伴骨髓增生异常和感音神经性听力损失,以及家族性骨髓增生异常综合征和急性髓性白血病。该病为常染色体显性遗传,但在大多数病例中,GATA2 基因的种系突变是新生的。该病的最初表现出现在成年早期,GATA2 缺乏症的病程长短不一,同一家族中基因变异相似的个体病程也可能不同。本文介绍了一例 GATA2 缺乏症的临床病例,患者在 7 岁时出现全身疣病、下肢淋巴结肿大、全身结核并累及腹腔、小骨盆和胸部器官。检查发现单核细胞、B淋巴细胞和NK淋巴细胞缺乏,骨髓增生异常综合征伴多线发育不良。我们将详细介绍原发性免疫缺陷病的临床表现和病程特点、检查结果和治疗方法。
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Features of the clinical picture and course of GATA2 deficiency complicated by generalized verrucosis with an outcome in myelodysplastic syndrome in adulthood
GATA2 deficiency is a rare disease belonging to the group of phagocyte birth defects, which is clinically manifested by four syndromes: MonoMac syndrome (myedysplasia and immunodeficiency associated with the development of infections caused by Mycobacterium avium complex); monocyte, dendritic cell, B- and NK-lymphocyte deficiency syndrome; Emberger syndrome, including primary lymphedema with myelodysplasia and sensorineural hearing loss, as well as familial myelodysplastic syndrome and acute myeloid leukemia. The disease is inherited by autosomal dominant type, but in most cases, mutations ofthe germ line of the GATA2 gene occur de novo. The first manifestations of the disease occur in early adulthood, the course of GATA2 deficiency is variable and may differ in individuals in the same family with similar genetic variants. The article presents a clinical case of manifestation of GATA2 deficiency at the age of seven years in the form of development of generalized verrucosis, lymphostasis of the lower limb, generalized tuberculosis with involvement of the abdominal cavity, small pelvis, and chest organs. The examination revealed deficiency of monocytes, B- and NK-lymphocytes, myelodysplastic syndrome with multilineage dysplasia. We present a detailed description of the clinical picture and peculiarities of the course of the primary immunodeficiency state, the results of the examination and treatment.
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