Journal of Clinical Immunology

, Volume 32, Issue 4, pp 698–708

Additional Diverse Findings Expand the Clinical Presentation of DOCK8 Deficiency

  • Ozden Sanal
  • Huie Jing
  • Tuba Ozgur
  • Deniz Ayvaz
  • Dara M. Strauss-Albee
  • Sibel Ersoy-Evans
  • Ilhan Tezcan
  • Gulten Turkkani
  • Helen F. Matthews
  • Goknur Haliloglu
  • Aysel Yuce
  • Bilgehan Yalcin
  • Ozay Gokoz
  • Kader K. Oguz
  • Helen C. Su
Article

DOI: 10.1007/s10875-012-9664-5

Cite this article as:
Sanal, O., Jing, H., Ozgur, T. et al. J Clin Immunol (2012) 32: 698. doi:10.1007/s10875-012-9664-5

Abstract

We describe seven Turkish children with DOCK8 deficiency who have not been previously reported. Three patients presented with typical features of recurrent or severe cutaneous viral infections, atopic dermatitis, and recurrent respiratory or gastrointestinal tract infections. However, four patients presented with other features. Patient 1–1 featured sclerosing cholangitis and colitis; patient 2–1, granulomatous soft tissue lesion and central nervous system involvement, with primary central nervous system lymphoma found on follow-up; patient 3–1, a fatal metastatic leiomyosarcoma; and patient 4–2 showed no other symptoms initially besides atopic dermatitis. Similar to other previously reported Turkish patients, but in contrast to patients of non-Turkish ethnicity, the patients’ lymphopenia was primarily restricted to CD4+ T cells. Patients had homozygous mutations in DOCK8 that altered splicing, introduced premature terminations, destabilized protein, or involved large deletions within the gene. Genotyping of remaining family members showed that DOCK8 deficiency is a fully penetrant, autosomal recessive disease. In our patients, bone marrow transplantation resulted in rapid improvement followed by disappearance of viral skin lesions, including lesions resembling epidermodysplasia verruciformis, atopic dermatitis, and recurrent infections. Particularly for patients who feature unusual clinical manifestations, immunological testing, in conjunction with genetic testing, can prove invaluable in diagnosing DOCK8 deficiency and providing potentially curative treatment.

Keywords

DOCK8 combined immunodeficiency epidermodysplasia verruciformis sclerosing cholangitis CNS lymphoma leiomyosarcoma 

Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2012

Authors and Affiliations

  • Ozden Sanal
    • 1
  • Huie Jing
    • 2
  • Tuba Ozgur
    • 1
  • Deniz Ayvaz
    • 1
  • Dara M. Strauss-Albee
    • 2
  • Sibel Ersoy-Evans
    • 3
  • Ilhan Tezcan
    • 1
  • Gulten Turkkani
    • 1
  • Helen F. Matthews
    • 4
  • Goknur Haliloglu
    • 5
  • Aysel Yuce
    • 6
  • Bilgehan Yalcin
    • 7
  • Ozay Gokoz
    • 8
  • Kader K. Oguz
    • 9
  • Helen C. Su
    • 2
  1. 1.Department of Pediatric ImmunologyHacettepe University Faculty of MedicineAnkaraTurkey
  2. 2.Laboratory of Host Defenses, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaUSA
  3. 3.Department of DermatologyHacettepe University Faculty of MedicineAnkaraTurkey
  4. 4.Laboratory of Immunology, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaUSA
  5. 5.Department of Pediatric NeurologyHacettepe University Faculty of MedicineAnkaraTurkey
  6. 6.Department of Pediatric GastroenterologyHacettepe University Faculty of MedicineAnkaraTurkey
  7. 7.Department of Pediatric OncologyHacettepe University Faculty of MedicineAnkaraTurkey
  8. 8.Department of PathologyHacettepe University Faculty of MedicineAnkaraTurkey
  9. 9.Department of RadiologyHacettepe University Faculty of MedicineAnkaraTurkey

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