Severe Enteropathy and Hypogammaglobulinemia Complicating Refractory Mycobacterium tuberculosis Complex Disseminated Disease in a Child with IL-12Rβ1 Deficiency

J Clin Immunol. 2017 Oct;37(7):732-738. doi: 10.1007/s10875-017-0435-1. Epub 2017 Sep 1.

Abstract

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-12Rβ1 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-12Rβ1 deficiency complicated with enteropathy and hypogammaglobulinemia and the first case of this disease to be described in Colombia.

Keywords: IL-12Rβ1 deficiency; Mycobacteria; enteropathy; hypogammaglobulinemia.

Publication types

  • Case Reports

MeSH terms

  • Agammaglobulinemia / drug therapy
  • Agammaglobulinemia / genetics*
  • BCG Vaccine
  • Candidiasis / drug therapy
  • Candidiasis / genetics*
  • Drug Resistance, Bacterial
  • Enteritis / drug therapy
  • Enteritis / genetics*
  • Genetic Predisposition to Disease
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / genetics*
  • Humans
  • Infant
  • Mutation
  • Mycobacterium tuberculosis
  • Receptors, Interleukin-12 / deficiency*
  • Receptors, Interleukin-12 / genetics*

Substances

  • BCG Vaccine
  • IL12RB1 protein, human
  • Receptors, Interleukin-12