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A Narrative Review of the Neurological Manifestations of Human Adenosine Deaminase 2 Deficiency.
Dzhus, Mariia; Ehlers, Lisa; Wouters, Marjon; Jansen, Katrien; Schrijvers, Rik; De Somer, Lien; Vanderschueren, Steven; Baggio, Marco; Moens, Leen; Verhaaren, Benjamin; Lories, Rik; Bucciol, Giorgia; Meyts, Isabelle.
Afiliação
  • Dzhus M; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium.
  • Ehlers L; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium.
  • Wouters M; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium.
  • Jansen K; Department of Development and Regeneration, Department of Pediatrics, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Schrijvers R; Department of General Internal Medicine-Allergy and Clinical Immunology, Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • De Somer L; Department of Pediatric Rheumatology, Laboratory of Immunobiology, Rega Institute, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, University Hospital Leuven and KU Leuven, Leuven, Belgium.
  • Vanderschueren S; Department of General Internal Medicine, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, Department of Microbiology, Immunology and Transplantation, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Baggio M; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium.
  • Moens L; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, KU Leuven, Leuven, Belgium.
  • Verhaaren B; Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
  • Lories R; Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Division of Rheumatology, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Bucciol G; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, Department of Pediatrics, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Meyts I; Department of Microbiology, Immunology and Transplantation, Inborn Errors of Immunity, Department of Pediatrics, European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, University Hospitals Leuven and KU Leuven, Leuven, Belgium. isabelle.meyts@uzleuven.be.
J Clin Immunol ; 43(8): 1916-1926, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37548813
ABSTRACT
Deficiency of human adenosine deaminase type 2 (DADA2) is a complex systemic autoinflammatory disorder characterized by vasculopathy, immune dysregulation, and hematologic abnormalities. The most notable neurological manifestations of DADA2 are strokes that can manifest with various neurological symptoms and are potentially fatal. However, neurological presentations can be diverse. We here present a review of the neurological manifestations of DADA2 to increase clinical awareness of DADA2 as the underlying diagnosis. We reviewed all published cases of DADA2 from 1 January 2014 until 19 July 2022 found via PubMed. A total of 129 articles describing the clinical features of DADA2 were included in the analysis. Six hundred twenty-eight patients diagnosed with DADA2 were included in the review. 50.3% of patients had at least signs of one reported neurological event, which was the initial or sole manifestation in 5.7% and 0.6%, respectively. 77.5% of patients with neurological manifestations had at least signs of one cerebrovascular accident, with lacunar strokes being the most common and 35.9% of them having multiple stroke episodes. There is a remarkable predilection for the brain stem and deep gray matter, with 37.3% and 41.6% of ischemic strokes, respectively. Other neurological involvement included neuropathies, focal neurological deficits, ophthalmological findings, convulsions, and headaches. In summary, neurological manifestations affect a significant proportion of patients with DADA2, and the phenotype is broad. Neurological manifestations can be the first and single manifestation of DADA2. Therefore, stroke, encephalitis, posterior reversible encephalopathy syndrome, mononeuropathy and polyneuropathy, and Behçet's disease-like presentations should prompt the neurologist to exclude DADA2, especially but not only in childhood.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Síndrome da Leucoencefalopatia Posterior Limite: Humans Idioma: En Revista: J Clin Immunol Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Síndrome da Leucoencefalopatia Posterior Limite: Humans Idioma: En Revista: J Clin Immunol Ano de publicação: 2023 Tipo de documento: Article