CNV results and clinical phenotypes of probands with autoimmune lymphoproliferative syndrome
. | Subject 1 (140.1) . | Subject 2 (384.1) . | Subject 3 (396.1) . |
---|---|---|---|
CNV results | |||
Size of copy number loss, Mb | 0.828 | 1.004 | 0.044 |
Exons affected | All | All | 7-9 |
Genomic location | 10q23.31 | 10q23.31 | 10q23.31 |
Probes, no. | 15 | 63 | 15 |
Parental studies | De novo copy number loss | Maternally inherited, mother with mild neutropenia and no other manifestations | Paternally inherited, father unaffected |
Clinical phenotypes | |||
Age, y | 34 | 11 | 14 |
Race | Caucasian | Asian | Caucasian |
Age of onset, y | 5 | 2 | 5 |
Presenting symptoms | Arthralgias, autoimmune fevers, diarrhea, and autoimmune hemolytic anemia, adenopathy, splenomegaly, pancytopenia, and follicular hyperplasia | Severe pancytopenia, hepatosplenomegaly, and lymphadenopathy | Fatigue, abdominal pain, cytopenias, lymphadenopathy, and splenomegaly |
Treatment | Prednisone pulses No sirolimus No mycophenolate | Mycophenolate | Mycophenolate with poor response, sirolimus with good effect |
Required criteria | |||
Splenomegaly | + | + | + |
Lymphadenopathy | + | + | + |
Elevated CD3+ αβ+ CD4−CD8− DNT cells (>1.5% of total lymphocytes or >2.5% of CD3+ lymphocytes) with normal or elevated lymphocyte counts | + | + | + |
Accessory criteria | |||
Primary criteria | |||
Defective FAS-induced apoptosis | + (22.2%; absolute of 325) | NR (9.25%; no absolute provided) | + |
Somatic or germline pathogenic mutation in FAS, FASL, FADD, or CASP10 | – | – | – |
Secondary criteria | |||
Hemolytic anemia | + | + | + |
Thrombocytopenia | + | + | + |
Neutropenia | + | + | + |
Serum elevated B12 levels (>1500 pg/mL) | + | + | + |
Elevated plasma sFASL levels (>200 pg/mL) | – | + (2193 pg/mL) | – |
Elevated plasma interleukin-10 levels (>20 pg/mL) | NR | + (27 pg/mL) | + |
Typical immunohistopathology findings (paracortical T-cell hyperplasia) | – | + | – |
Elevated immunoglobulin G levels (polyclonal hypergammaglobinemia) | + | + | + |
Family history of a nonmalignant or lymphoma-associated noninfectious lymphoproliferation with or without autoimmunity | – | – | – |
. | Subject 1 (140.1) . | Subject 2 (384.1) . | Subject 3 (396.1) . |
---|---|---|---|
CNV results | |||
Size of copy number loss, Mb | 0.828 | 1.004 | 0.044 |
Exons affected | All | All | 7-9 |
Genomic location | 10q23.31 | 10q23.31 | 10q23.31 |
Probes, no. | 15 | 63 | 15 |
Parental studies | De novo copy number loss | Maternally inherited, mother with mild neutropenia and no other manifestations | Paternally inherited, father unaffected |
Clinical phenotypes | |||
Age, y | 34 | 11 | 14 |
Race | Caucasian | Asian | Caucasian |
Age of onset, y | 5 | 2 | 5 |
Presenting symptoms | Arthralgias, autoimmune fevers, diarrhea, and autoimmune hemolytic anemia, adenopathy, splenomegaly, pancytopenia, and follicular hyperplasia | Severe pancytopenia, hepatosplenomegaly, and lymphadenopathy | Fatigue, abdominal pain, cytopenias, lymphadenopathy, and splenomegaly |
Treatment | Prednisone pulses No sirolimus No mycophenolate | Mycophenolate | Mycophenolate with poor response, sirolimus with good effect |
Required criteria | |||
Splenomegaly | + | + | + |
Lymphadenopathy | + | + | + |
Elevated CD3+ αβ+ CD4−CD8− DNT cells (>1.5% of total lymphocytes or >2.5% of CD3+ lymphocytes) with normal or elevated lymphocyte counts | + | + | + |
Accessory criteria | |||
Primary criteria | |||
Defective FAS-induced apoptosis | + (22.2%; absolute of 325) | NR (9.25%; no absolute provided) | + |
Somatic or germline pathogenic mutation in FAS, FASL, FADD, or CASP10 | – | – | – |
Secondary criteria | |||
Hemolytic anemia | + | + | + |
Thrombocytopenia | + | + | + |
Neutropenia | + | + | + |
Serum elevated B12 levels (>1500 pg/mL) | + | + | + |
Elevated plasma sFASL levels (>200 pg/mL) | – | + (2193 pg/mL) | – |
Elevated plasma interleukin-10 levels (>20 pg/mL) | NR | + (27 pg/mL) | + |
Typical immunohistopathology findings (paracortical T-cell hyperplasia) | – | + | – |
Elevated immunoglobulin G levels (polyclonal hypergammaglobinemia) | + | + | + |
Family history of a nonmalignant or lymphoma-associated noninfectious lymphoproliferation with or without autoimmunity | – | – | – |
NR, not reported.