Is Your Kid Actin Out? A Series of Six Patients With Inherited Actin-Related Protein 2/3 Complex Subunit 1B Deficiency and Review of the Literature.

BACKGROUND: Hereditary actin-related protein 2/3 complex subunit 1B deficiency is characterized clinically by ear, skin, and lung infections, bleeding, eczema, food allergy, asthma, skin vasculitis, colitis, arthritis, short stature, and lymphadenopathy. OBJECTIVE: We aimed to describe the clinical, laboratory, and genetic features of six patients from four Mexican families. METHODS: We performed exome sequencing in patients of four families with suspected actinopathy, collected their data from medical records, and reviewed the literature for reports of other patients with actin-related protein 2/3 complex subunit 1B deficiency. RESULTS: Six patients from four families were included. All had recurrent infections, mainly bacterial pneumonia, and cellulitis. A total of 67% had eczema whereas 50% had food allergies, failure to thrive, hepatomegaly, and bleeding. Eosinophilia was found in all; 84% had thrombocytopenia, 67% had abnormal-size platelets and anemia. Serum levels of IgG, IgA, and IgE were highly increased in most; IgM was normal or low. T cells were decreased in 67% of patients, whereas B and NK cells were increased in half of patients. Two of the four probands had compound heterozygous variants. One patient was successfully transplanted. We identified 28 other patients whose most prevalent features were eczema, recurrent infections, failure to thrive, bleeding, diarrhea, allergies, vasculitis, eosinophilia, platelet abnormalities, high IgE/IgA, low T cells, and high B cells. CONCLUSION: Actin-related protein 2/3 complex subunit 1B deficiency has a variable and heterogeneous clinical spectrum, expanded by these cases to include keloid scars and Epstein-Barr virus chronic hepatitis. A novel deletion in exon 8 was shared by three unrelated families and might be the result of a founder effect.

[Cartilage-hair hypoplasia. A case report]. / Hipoplasia cartílago-cabello. Reporte de un caso.

BACKGROUND: Cartilage-hair hypoplasia is a rare autosomal recessive disease, which is characterized by metaphyseal chondrodysplasia and thin hair. It can be accompanied by immunological disorders in varying degrees. CLINICAL CASE: The case of a 35-month-old girl is described. Since her birth, with growth restriction, she has developed pneumonia eleven times, malabsorption syndrome and aganglionic megacolon, which is why she was diagnosed with cartilage-hair hypoplasia, with expression of non-severe combined immunodeficiency. The decision was to proceed with hematopoietic stem cell transplantation. At the time of this report, the patient was free from infectious processes. CONCLUSION: Cartilage-hair hypoplasia is a condition with diverse clinical features and different degrees of immunodeficiency. As part of the treatment, it is possible to perform haematopoietic stem cell transplantation.

Antecedentes: La hipoplasia cartílago-cabello es una enfermedad autosómica recesiva poco frecuente, caracterizada por condrodisplasia metafisaria y cabello fino. Puede estar acompañada de alteraciones inmunológicas en distintos grados. Caso clínico: Niña de 35 meses de edad, quien desde su nacimiento mostró restricción del crecimiento; desarrolló 11 cuadros de neumonía, síndrome de malabsorción y megacolon agangliónico, por lo que se diagnosticó hipoplasia cartílago-cabello, con expresión de inmunodeficiencia combinada no severa. Se decidió trasplante de células madre hematopoyéticas. Al momento de este informe, la paciente estaba libre de procesos infecciosos. Conclusión: La hipoplasia cartílago-cabello es un padecimiento con rasgos clínicos y distintos grados de inmunodeficiencia. Como parte del tratamiento es posible realizar trasplante de células madre hematopoyéticas.

[Experience in the management of pediatric patients with Gaucher disease]. / Experiencia en el manejo de pacientes pediátricos con enfermedad de Gaucher.

Among lysosomal storage diseases, Gaucher disease depicts the highest rate of incidence, according with the international epidemiological reports. Gaucher disease is due to an impairing of the acid beta-glucosidase enzyme, since its lack promotes accumulation of the sphingolipid glucosylceramide at macrophages, leading to heterogeneous multiorganic damage (visceral, skeletal, and central nervous system affectation). This paper portrays a series of clinical cases of Gaucher disease with patients treated at the same city (Monterrey, Nuevo León), at the Paediatric Haematology Department of the Specialties General Hospital, UMAE 25, in Monterrey of the Instituto Mexicano del Seguro Social. Gaucher disease is symptomatic since early childhood in a good proportion of patients. The patients in this serie was treated with enzyme replacement therapy, and share the typical overall features of the disease.

Seguimiento de siete años de 20 pacientes hemofílicos infectados con VIH / Seven-year follow-up of 20 HIV positive hemophilic patients

El 1986 detectamos que veinticuatro pacientes (28.3 por ciento) del grupo de hemofílicos de grado moderado a grave de nuestro hospital, tenían anticuerpos séricos contra el virus de la inmunodeficiencia humana; veinte estaban asintomáticos. Después de siete años de seguimiento, encontramos que sólo tres de los 20 (15 por ciento) permanecían asintomáticos y diecisiete (85 por ciento) habían desarrollado el síndrome de inmunodeficiencia adquirida; el tiempo medio de desarrollo de SIDA fue de cuatro años ocho meses. Catorce pacientes (70 por ciento) habián fallecido al cierre del estudio; el tiempo medio entre el desarrollo del síndrome de inmunodeficiencia adquirida y la muerte fue de 11 meses. Sólo cuatro de los pacientes que fallecieron recibieron zidovudina, y en ellos se observó que la sobrevida media fue de dos años ocho meses