Severe Enteropathy and Hypogammaglobulinemia Complicating Refractory Mycobacterium tuberculosis Complex Disseminated Disease in a Child with IL-12Rß1 Deficiency.

PURPOSE: Mendelian susceptibility to mycobacterial disease is a rare clinical condition characterized by a predisposition to infectious diseases caused by poorly virulent mycobacteria. Other infections such as salmonellosis and candidiasis are also reported. The purpose of this article is to describe a young boy affected with various infectious diseases caused by Mycobacterium tuberculosis complex, Salmonella sp, Klebsiella pneumonie, Citrobacter sp., and Candida sp, complicated with severe enteropathy and transient hypogammaglobulinemia. METHODS: We reviewed medical records and performed flow cytometry staining for lymphocyte populations, lymphocyte proliferation in response to PHA, and intracellular IFN-γ production in T cell PHA blasts in the patient and a healthy control. Sanger sequencing was used to confirm the genetic variants in the patient and relatives. RESULTS: Genetic analysis revealed a bi-allelic mutation in IL12RB1 (C291Y) resulting in complete IL-12Rß1 deficiency. Functional analysis demonstrated the lack of intracellular production of IFN-γ in CD3+ T lymphocytes from the patient in response to rhIL-12p70. CONCLUSIONS: To our knowledge, this is the third patient with MSMD due to IL-12Rß1 deficiency complicated with enteropathy and hypogammaglobulinemia and the first case of this disease to be described in Colombia.

Variabilidad genotipo fenotipo en encefalopatía neurogastrointestinalmitocondrial MNGIE por una mutación sin codón de parada / Genotype phenotype variation in mitochondrial neurogatrointestinal encephalopathy MNGIE because of a mutation without stop codon

La encefalopatía neurogastrointestinal mitocondrial (MNGIE) es una enfermedad genética que se manifiestadesde los primeros años de vida con episodios de íleo, obstrucción intestinal, trastorno de deglución, falla demedro, miopatía, neuropatía periférica y leucoencefalopatía. Sin embargo, las manifestaciones clínicas puedenser leves o incompletas. En la mayoría de los casos es producto de una mutación de novo, pero también puedeheredarse de forma autosómica recesiva. Específicamente, la mutación c.1416 se asocia a MNGIE con neuropatíaperiférica severa. A continuación se describe el debut, características clínicas, hallazgos bioquímicos,neuroimagen y confirmación de la mutación c.1416 de un paciente con MNGIE pero sin enfermedad demotoneurona inferior...

Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is a genetic disease with onset from infancy andexpressed with bowel obstruction, swallowing disorder, growth retardation, myopathy, peripheral neuropathyand cerebral leukoencephalopathy. The majority of cases are produced by a novo mutation and sometimes byan autosomic reccessive inheretance. MNGIE produced by c.1416 mutation has been associated with severeperipheral neuropathy. In the following report, we describe the onset disease, clinical features, biochemicaldata, cerebral magnetic resonance image, genetic test and literature review of a patient with MNGIE withoutinferior motoneuron disease and c.1416 mutation...