A familial case of B-cell expansion with NF-κB and T-cell anergy caused by a G123D heterozygous missense mutation in the CARD11 gene

Pediatr Blood Cancer. 2022 Dec;69(12):e29941. doi: 10.1002/pbc.29941. Epub 2022 Sep 21.

Abstract

B-cell expansion with NF-κB (nuclear factor-kappa B) and T-cell anergy (BENTA) is a rare congenital lymphoproliferative disorder caused by germline gain-of-function mutations in the CARD11 gene. We herein report a familial case of BENTA due to a G123D heterozygous missense mutation in CARD11 inherited by a male from his mother. The mother's clinical course was characterized by polyarthritis and encephalitis in young adulthood, suggesting that autoimmune-like manifestations can occur in BENTA. The B-cell lymphocytosis and splenomegaly seen in her child have been managed with prednisolone and tacrolimus. Further investigations are needed to evaluate the efficacy of calcineurin inhibitors for BENTA.

Keywords: B-cell expansion with NF-κB and T-cell anergy (BENTA); CARD11; autoimmune-like manifestations; familial case; tacrolimus.

MeSH terms

  • Adult
  • B-Lymphocytes / metabolism
  • CARD Signaling Adaptor Proteins / genetics
  • CARD Signaling Adaptor Proteins / metabolism
  • Child
  • Female
  • Guanylate Cyclase / genetics
  • Guanylate Cyclase / metabolism
  • Humans
  • Immunologic Deficiency Syndromes*
  • Male
  • Mutation
  • Mutation, Missense
  • NF-kappa B* / genetics
  • NF-kappa B* / metabolism
  • T-Lymphocytes / metabolism
  • Young Adult

Substances

  • NF-kappa B
  • CARD Signaling Adaptor Proteins
  • Guanylate Cyclase
  • CARD11 protein, human