[Ichtyosiform erythroderma revealing a severe combined immunodeficiency]. / Érythrodermie ichtyosiforme révélant un déficit immunitaire combiné sévère.
Ann Dermatol Venereol
; 147(2): 131-134, 2020 Feb.
Article
in Fr
| MEDLINE
| ID: mdl-31973905
ABSTRACT
BACKGROUND:
Severe combined immunodeficiency (SCID) is a the most severe form of primary immunodeficiency and is highly heterogeneous. We report an atypical form of SCID revealed by exfoliative erythroderma. PATIENTS ANDMETHODS:
A 3-month-old boy, born to consanguineous parents, was admitted to the dermatology department with exfoliative erythroderma associated with eczematous patches and alopecia of the scalp, eyelashes, and eyebrows, but with no lymphadenopathy or hepatosplenomegaly. He displayed chronic diarrhea and recurrent infection since birth. A complete blood count showed marked leukocytosis with eosinophilia and lymphocytosis. These clinical and biological findings improved partly with topical steroids. The patient no longer had erythroderma and showed regrowth of hair, eyelashes and eyebrows. The subsequent CBC showed less marked eosinophilia with mild lymphopenia and no leukocytosis. Immunoglobulin levels were undetectable. Primary immunodeficiency was discussed. Immunological investigations concluded on a diagnosis of T-B-NK+ SCID. Mutation analysis revealed a homozygous c.1338C>G (pCys446Trp) mutation in the RAG2 gene. Hematopoietic stem cell transplantation is planned in the near future.CONCLUSION:
This case illustrates atypical T-B-NK+ SCID revealed by severe exfoliative erythroderma in a 3-month-old boy with RAG2 gene mutation. Neonatal erythroderma must be considered a warning sign of primary immunodeficiency requiring immediate immunological phenotyping as well as genetic testing for a definitive diagnosis.Key words
Full text:
1
Collection:
01-internacional
Health context:
3_ND
Database:
MEDLINE
Main subject:
Severe Combined Immunodeficiency
/
Dermatitis, Exfoliative
Type of study:
Etiology_studies
Limits:
Humans
/
Infant
/
Male
Language:
Fr
Journal:
Ann Dermatol Venereol
Year:
2020
Document type:
Article