Table 2.

Heterozygous variants in 15 of 29 patients with acquired HLH

PatientAge, yDiseaseGenes (n of variants)*NK cell functions
Perforin expressionDegranulationDirect cytotoxicity
71 Lymphoma LYST (×1), UNC13D (×2) 
76 Idiopathic PRF1 (×1), UNC13D (×1), LYST (×1) 
32 Bacterial infection LYST (×7) — 
85 Idiopathic PRF1 (×1) 
70 Idiopathic LYST (×1) ↓ — — 
78 Bacterial infection STX11 (×1) 
87 Lymphoma LYST (×1) 
58 Parasitic infection LYST (×1) 
63 Parasitic infection PRF1 (×1) 
10 33 SLE UNC13D (×1) ↓ — 
11 91 Idiopathic PRF1 (×1) ↓ ↓ ↓ 
12 70 Idiopathic PRF1 (×1), UNC13D (×1), LYST (×1) 
13 60 Idiopathic UNC13D (×1) — — — 
14 61 Bacterial infection UNC13D (×1) 
15 63 Lymphoma PRF1 (×1), UNC13D (×1) — 
PatientAge, yDiseaseGenes (n of variants)*NK cell functions
Perforin expressionDegranulationDirect cytotoxicity
71 Lymphoma LYST (×1), UNC13D (×2) 
76 Idiopathic PRF1 (×1), UNC13D (×1), LYST (×1) 
32 Bacterial infection LYST (×7) — 
85 Idiopathic PRF1 (×1) 
70 Idiopathic LYST (×1) ↓ — — 
78 Bacterial infection STX11 (×1) 
87 Lymphoma LYST (×1) 
58 Parasitic infection LYST (×1) 
63 Parasitic infection PRF1 (×1) 
10 33 SLE UNC13D (×1) ↓ — 
11 91 Idiopathic PRF1 (×1) ↓ ↓ ↓ 
12 70 Idiopathic PRF1 (×1), UNC13D (×1), LYST (×1) 
13 60 Idiopathic UNC13D (×1) — — — 
14 61 Bacterial infection UNC13D (×1) 
15 63 Lymphoma PRF1 (×1), UNC13D (×1) — 

—, not done; N, normal; SLE, systemic lupus erythematosus.

*

PRF1, perforin gene (biallelic mutation = FHL2); UNC13D, MUNC13-4 gene (biallelic mutation = FHL3); STX11, syntaxin 11 gene (biallelic mutation = FHL5); LYST (biallelic mutation = Chediak-Higashi syndrome); no heterozygous mutations with the selective criteria were found for STXBP2, SH2D1A, RAB27A, XIAP, or ITK genes.

Variant known as pathogenic.

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