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{{Autoimmune lymphoproliferative syndrome}}
{{Autoimmune lymphoproliferative syndrome}}
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{{CMG}} {{AE}} {{SharmiB}}
 
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==Overview==
==Overview==
[[Autoimmune lymphoproliferative syndrome]]([[ALPS]]) is a rare [[genetic]] [[disorder]] which predominantly manifests in early [[childhood]]. Due to the overlapping [[symptoms]] of [[lymphadenopathy]], [[cytopenia]], and [[splenomegaly]]; [[ALPS]] often is misdiagnosed or undiagnosed. A [[genetic]] test to detect FAS [[mutation]] is required to confirm the [[diagnosis]]. The majority of [[ALPS]] is curable by early adulthood. [[Patients]] with ALPS are at risk of developing lymphoma, therefore routine monitoring is required. Initially, [[ALPS]] was described as [[Canale-Smith syndrome]]. In 1990, it was described as [[ALPS]]. In 2009, guidelines for [[diagnosis]] and [[classification]] of [[ALPS]] were revised in an international workshop.


==Historical Perspective==
==Historical Perspective==


* [[Autoimmune]] [[Lymphoproliferative]] [[Syndrome]] was first discovered by Canale and Smith, in 1967.Five [[patients]] were reported with [[lymphadenopathy]], [[cytopenia]] and [[splenomegaly]].<ref name="ÖrenÖzkal2002">{{cite journal|last1=Ören|first1=Hale|last2=Özkal|first2=Sermin|last3=Gülen|first3=Hüseyin|last4=Duman|first4=Murat|last5=Uçar|first5=Canan|last6=Atabay|first6=Berna|last7=Yılmaz|first7=Şebnem|last8=Kargı|first8=Aydanur|last9=İrken|first9=Gülersu|title=Autoimmune lymphoproliferative syndrome: report of two cases and review of the literature|journal=Annals of Hematology|volume=81|issue=11|year=2002|pages=651–653|issn=0939-5555|doi=10.1007/s00277-002-0537-5}}</ref> <ref name="JacksonFischer1999">{{cite journal|last1=Jackson|first1=Christine E.|last2=Fischer|first2=Roxanne E.|last3=Hsu|first3=Amy P.|last4=Anderson|first4=Stacie M.|last5=Choi|first5=Youngnim|last6=Wang|first6=Jin|last7=Dale|first7=Janet K.|last8=Fleisher|first8=Thomas A.|last9=Middelton|first9=Lindsay A.|last10=Sneller|first10=Michael C.|last11=Lenardo|first11=Michael J.|last12=Straus|first12=Stephen E.|last13=Puck|first13=Jennifer M.|title=Autoimmune Lymphoproliferative Syndrome with Defective Fas: Genotype Influences Penetrance|journal=The American Journal of Human Genetics|volume=64|issue=4|year=1999|pages=1002–1014|issn=00029297|doi=10.1086/302333}}</ref>
*[[Autoimmune]] [[Lymphoproliferative]] [[Syndrome]] was first discovered by Canale and Smith, in 1967.Five [[patients]] were reported with [[lymphadenopathy]], [[cytopenia]] and [[splenomegaly]].<ref name="ÖrenÖzkal2002">{{cite journal|last1=Ören|first1=Hale|last2=Özkal|first2=Sermin|last3=Gülen|first3=Hüseyin|last4=Duman|first4=Murat|last5=Uçar|first5=Canan|last6=Atabay|first6=Berna|last7=Yılmaz|first7=Şebnem|last8=Kargı|first8=Aydanur|last9=İrken|first9=Gülersu|title=Autoimmune lymphoproliferative syndrome: report of two cases and review of the literature|journal=Annals of Hematology|volume=81|issue=11|year=2002|pages=651–653|issn=0939-5555|doi=10.1007/s00277-002-0537-5}}</ref> <ref name="JacksonFischer1999">{{cite journal|last1=Jackson|first1=Christine E.|last2=Fischer|first2=Roxanne E.|last3=Hsu|first3=Amy P.|last4=Anderson|first4=Stacie M.|last5=Choi|first5=Youngnim|last6=Wang|first6=Jin|last7=Dale|first7=Janet K.|last8=Fleisher|first8=Thomas A.|last9=Middelton|first9=Lindsay A.|last10=Sneller|first10=Michael C.|last11=Lenardo|first11=Michael J.|last12=Straus|first12=Stephen E.|last13=Puck|first13=Jennifer M.|title=Autoimmune Lymphoproliferative Syndrome with Defective Fas: Genotype Influences Penetrance|journal=The American Journal of Human Genetics|volume=64|issue=4|year=1999|pages=1002–1014|issn=00029297|doi=10.1086/302333}}</ref>
* The [[syndrome]] was initially named as Canale-Smith [[Syndrome]].  
*The [[syndrome]] was initially named as Canale-Smith [[Syndrome]].
* In 1990, [[ALPS]] was first characterized
*In 1990, [[ALPS]] was first characterized
* In 1992, a [[mutation]] of lpr([[lymphoproliferation]] [[phenotype]]) and gld(generalized [[lymphoproliferative]] [[disease]] [[phenotype]]), a [[human]] equivalent of [[murine]] [[disease]] is reported.
*In 1992, a [[mutation]] of lpr ([[lymphoproliferation]] [[phenotype]]) and gld (generalized [[lymphoproliferative]] [[disease]] [[phenotype]]), a [[human]] equivalent of [[murine]] [[disease]] is reported.
*In 1995, association between inborn [[mutation]] of [[Fas]] [[gene]] and the [[development]] of [[Autoimmune]] [[lymphoproliferative]] [[syndrome]] was discovered.
*In 1995, association between inborn [[mutation]] of [[Fas]] [[gene]] and the [[development]] of [[Autoimmune]] [[lymphoproliferative]] [[syndrome]] was discovered.
*In 2003, new [[mutation]] in [[Fas]] [[Ligand]] (FasL) [[gene mutation]] and [[caspase 8]] or 10 [[gene]] [[mutations]].
*In 2003, new [[mutation]] in [[Fas]] [[Ligand]] (FasL) [[gene mutation]] and [[caspase 8]] or 10 [[gene]] [[mutations]].


===Landmark Events in the Development of Treatment Strategies===
===Landmark Events in the Development of Treatment Strategies===
* In 1995, FAS [[gene]] [[mutation]] in [[ALPS]] was discovered.<ref name="FisherRosenberg1995">{{cite journal|last1=Fisher|first1=Galen H|last2=Rosenberg|first2=Fredric J|last3=Straus|first3=Stephen E|last4=Dale|first4=Janet K|last5=Middelton|first5=Lindsay A|last6=Lin|first6=Albert Y|last7=Strober|first7=Warren|last8=Lenardo|first8=Michael J|last9=Puck|first9=Jennifer M|title=Dominant interfering fas gene mutations impair apoptosis in a human autoimmune lymphoproliferative syndrome|journal=Cell|volume=81|issue=6|year=1995|pages=935–946|issn=00928674|doi=10.1016/0092-8674(95)90013-6}}</ref>
* In 2009, an international workshop held at NIH in Uthe United States, announced revised diagnostic criteria and classification of ALPS.<ref name="OliveiraBleesing2010">{{cite journal|last1=Oliveira|first1=Joao B.|last2=Bleesing|first2=Jack J.|last3=Dianzani|first3=Umberto|last4=Fleisher|first4=Thomas A.|last5=Jaffe|first5=Elaine S.|last6=Lenardo|first6=Michael J.|last7=Rieux-Laucat|first7=Frederic|last8=Siegel|first8=Richard M.|last9=Su|first9=Helen C.|last10=Teachey|first10=David T.|last11=Rao|first11=V. Koneti|title=Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop|journal=Blood|volume=116|issue=14|year=2010|pages=e35–e40|issn=0006-4971|doi=10.1182/blood-2010-04-280347}}</ref>
* In 2017, mTOR inhibitor found to be an effective treatment for cytopenias related to ALPS.<ref name="KlemannEsquivel2017">{{cite journal|last1=Klemann|first1=Christian|last2=Esquivel|first2=Myrian|last3=Magerus-Chatinet|first3=Aude|last4=Lorenz|first4=Myriam R.|last5=Fuchs|first5=Ilka|last6=Neveux|first6=Nathalie|last7=Castelle|first7=Martin|last8=Rohr|first8=Jan|last9=da Cunha|first9=Claudia Bettoni|last10=Ebinger|first10=Martin|last11=Kobbe|first11=Robin|last12=Kremens|first12=Bernhard|last13=Kollert|first13=Florian|last14=Gambineri|first14=Eleonora|last15=Lehmberg|first15=Kai|last16=Seidel|first16=Markus G.|last17=Siepermann|first17=Kathrin|last18=Voelker|first18=Thomas|last19=Schuster|first19=Volker|last20=Goldacker|first20=Sigune|last21=Schwarz|first21=Klaus|last22=Speckmann|first22=Carsten|last23=Picard|first23=Capucine|last24=Fischer|first24=Alain|last25=Rieux-Laucat|first25=Frederic|last26=Ehl|first26=Stephan|last27=Rensing-Ehl|first27=Anne|last28=Neven|first28=Benedicte|title=Evolution of disease activity and biomarkers on and off rapamycin in 28 patients with autoimmune lymphoproliferative syndrome|journal=Haematologica|volume=102|issue=2|year=2017|pages=e52–e56|issn=0390-6078|doi=10.3324/haematol.2016.153411}}</ref>
===Impact on Cultural History===


===Famous Cases===
*In 1995, FAS [[gene]] [[mutation]] in [[ALPS]] was discovered.<ref name="FisherRosenberg1995">{{cite journal|last1=Fisher|first1=Galen H|last2=Rosenberg|first2=Fredric J|last3=Straus|first3=Stephen E|last4=Dale|first4=Janet K|last5=Middelton|first5=Lindsay A|last6=Lin|first6=Albert Y|last7=Strober|first7=Warren|last8=Lenardo|first8=Michael J|last9=Puck|first9=Jennifer M|title=Dominant interfering fas gene mutations impair apoptosis in a human autoimmune lymphoproliferative syndrome|journal=Cell|volume=81|issue=6|year=1995|pages=935–946|issn=00928674|doi=10.1016/0092-8674(95)90013-6}}</ref>
The following are a few famous cases of [disease name]:
*In 2009, an international workshop held at NIH in Uthe United States, announced revised diagnostic criteria and classification of ALPS.<ref name="OliveiraBleesing2010">{{cite journal|last1=Oliveira|first1=Joao B.|last2=Bleesing|first2=Jack J.|last3=Dianzani|first3=Umberto|last4=Fleisher|first4=Thomas A.|last5=Jaffe|first5=Elaine S.|last6=Lenardo|first6=Michael J.|last7=Rieux-Laucat|first7=Frederic|last8=Siegel|first8=Richard M.|last9=Su|first9=Helen C.|last10=Teachey|first10=David T.|last11=Rao|first11=V. Koneti|title=Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop|journal=Blood|volume=116|issue=14|year=2010|pages=e35–e40|issn=0006-4971|doi=10.1182/blood-2010-04-280347}}</ref>
*In 2017, [[mTOR]] [[inhibitor]] found to be an effective [[treatment]] for [[treatment]] refractory [[cytopenias]] related to [[ALPS]].<ref name="KlemannEsquivel2017">{{cite journal|last1=Klemann|first1=Christian|last2=Esquivel|first2=Myrian|last3=Magerus-Chatinet|first3=Aude|last4=Lorenz|first4=Myriam R.|last5=Fuchs|first5=Ilka|last6=Neveux|first6=Nathalie|last7=Castelle|first7=Martin|last8=Rohr|first8=Jan|last9=da Cunha|first9=Claudia Bettoni|last10=Ebinger|first10=Martin|last11=Kobbe|first11=Robin|last12=Kremens|first12=Bernhard|last13=Kollert|first13=Florian|last14=Gambineri|first14=Eleonora|last15=Lehmberg|first15=Kai|last16=Seidel|first16=Markus G.|last17=Siepermann|first17=Kathrin|last18=Voelker|first18=Thomas|last19=Schuster|first19=Volker|last20=Goldacker|first20=Sigune|last21=Schwarz|first21=Klaus|last22=Speckmann|first22=Carsten|last23=Picard|first23=Capucine|last24=Fischer|first24=Alain|last25=Rieux-Laucat|first25=Frederic|last26=Ehl|first26=Stephan|last27=Rensing-Ehl|first27=Anne|last28=Neven|first28=Benedicte|title=Evolution of disease activity and biomarkers on and off rapamycin in 28 patients with autoimmune lymphoproliferative syndrome|journal=Haematologica|volume=102|issue=2|year=2017|pages=e52–e56|issn=0390-6078|doi=10.3324/haematol.2016.153411}}</ref>


==References==
==References==
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Latest revision as of 19:31, 17 September 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S

Overview

Autoimmune lymphoproliferative syndrome(ALPS) is a rare genetic disorder which predominantly manifests in early childhood. Due to the overlapping symptoms of lymphadenopathy, cytopenia, and splenomegaly; ALPS often is misdiagnosed or undiagnosed. A genetic test to detect FAS mutation is required to confirm the diagnosis. The majority of ALPS is curable by early adulthood. Patients with ALPS are at risk of developing lymphoma, therefore routine monitoring is required. Initially, ALPS was described as Canale-Smith syndrome. In 1990, it was described as ALPS. In 2009, guidelines for diagnosis and classification of ALPS were revised in an international workshop.

Historical Perspective

Landmark Events in the Development of Treatment Strategies

References

  1. Ören, Hale; Özkal, Sermin; Gülen, Hüseyin; Duman, Murat; Uçar, Canan; Atabay, Berna; Yılmaz, Şebnem; Kargı, Aydanur; İrken, Gülersu (2002). "Autoimmune lymphoproliferative syndrome: report of two cases and review of the literature". Annals of Hematology. 81 (11): 651–653. doi:10.1007/s00277-002-0537-5. ISSN 0939-5555.
  2. Jackson, Christine E.; Fischer, Roxanne E.; Hsu, Amy P.; Anderson, Stacie M.; Choi, Youngnim; Wang, Jin; Dale, Janet K.; Fleisher, Thomas A.; Middelton, Lindsay A.; Sneller, Michael C.; Lenardo, Michael J.; Straus, Stephen E.; Puck, Jennifer M. (1999). "Autoimmune Lymphoproliferative Syndrome with Defective Fas: Genotype Influences Penetrance". The American Journal of Human Genetics. 64 (4): 1002–1014. doi:10.1086/302333. ISSN 0002-9297.
  3. Fisher, Galen H; Rosenberg, Fredric J; Straus, Stephen E; Dale, Janet K; Middelton, Lindsay A; Lin, Albert Y; Strober, Warren; Lenardo, Michael J; Puck, Jennifer M (1995). "Dominant interfering fas gene mutations impair apoptosis in a human autoimmune lymphoproliferative syndrome". Cell. 81 (6): 935–946. doi:10.1016/0092-8674(95)90013-6. ISSN 0092-8674.
  4. Oliveira, Joao B.; Bleesing, Jack J.; Dianzani, Umberto; Fleisher, Thomas A.; Jaffe, Elaine S.; Lenardo, Michael J.; Rieux-Laucat, Frederic; Siegel, Richard M.; Su, Helen C.; Teachey, David T.; Rao, V. Koneti (2010). "Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop". Blood. 116 (14): e35–e40. doi:10.1182/blood-2010-04-280347. ISSN 0006-4971.
  5. Klemann, Christian; Esquivel, Myrian; Magerus-Chatinet, Aude; Lorenz, Myriam R.; Fuchs, Ilka; Neveux, Nathalie; Castelle, Martin; Rohr, Jan; da Cunha, Claudia Bettoni; Ebinger, Martin; Kobbe, Robin; Kremens, Bernhard; Kollert, Florian; Gambineri, Eleonora; Lehmberg, Kai; Seidel, Markus G.; Siepermann, Kathrin; Voelker, Thomas; Schuster, Volker; Goldacker, Sigune; Schwarz, Klaus; Speckmann, Carsten; Picard, Capucine; Fischer, Alain; Rieux-Laucat, Frederic; Ehl, Stephan; Rensing-Ehl, Anne; Neven, Benedicte (2017). "Evolution of disease activity and biomarkers on and off rapamycin in 28 patients with autoimmune lymphoproliferative syndrome". Haematologica. 102 (2): e52–e56. doi:10.3324/haematol.2016.153411. ISSN 0390-6078.