X-linked lymphoproliferative syndrome type 1 complicated with secondary hemophagocytic lymphohistiocytosis and ileal perforation: case report and literature review
10.3760/cma.j.issn.0578-1310.2016.04.013
- VernacularTitle:X连锁淋巴细胞异常增生症1型继发噬血细胞性淋巴组织细胞增生症合并回肠穿孔一例并文献复习
- Author:
Li XIAO
1
;
Xianmin GUAN
;
Yan MENG
;
Xiaodong ZHAO
;
Ying XIAN
;
Yunfei AN
;
Jie YU
Author Information
1. 400014,重庆医科大学附属儿童医院血液肿瘤科
- Keywords:
Lymphohistiocytosis,hemophagocytic;
Herpesvirus 4,human;
Intestinal perforation
- From:
Chinese Journal of Pediatrics
2016;54(4):290-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze and summarize the clinical characteristics,laboratory tests and treatment of X-linked lymphoproliferative syndrome type 1 (XLP-1).Method A retrospective study was done in 2012 on an XLP-1 patient to collect the data on clinical manifestation,laboratory examination,gene and protein expression,complications and prognosis.Literatures were reviewed in Pubmed with the key word " X-linked lymphoproliferative syndrome" Result The patient with persistent high fever,jaundice,abdominal distension,hepatosplenomegaly and lymphadenectasis,rash and suspicious positive family history;the patient eventually died of hemophagocytic lymphohistiocytosis (HLH),with intestinal perforation,intestinal infection and bleeding after being infected with EB virus.This patient with SH2D1A gene exon 1 large fragment of the coding region of the nucleotide deletion and insertion mutations causing missense mutations (p.Leu25Lys) and nonsense mutations (stop codon TAG was inserted after missense mutation so that the protein encoded by the early termination of the 25 amino acids),which led to SAP protein missing.The expression of SAP in his mother was also partly missing.Retrieval of reports on XLP-1 was conducted through literature search (included totally 157 cases) at home and abroad,positive family history accounted for 60.6％ (40/66);lymphoma incidence accounted for 49.7％ (72/145);low gamma globulin occurred in 24.8％ (39/157) of cases;secondary HLH ratio accounted for 43.3％ (68/157);XLP-1 in patients with hemorrhagic enteritis and gastritis was low,accounted for only 2.6％ (3/116).Conclusion XLP-1 patients occasionally develop necrotic enteritis complicated with ileal perforation.XLP-1 with large fragment deletion of SH2D1A gene might be associated with serious gastrointestinal manifestations.
