Combined immunodeficiency: Difference between revisions

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{{ID}}
{{ID}}
{{CMG}}; {{AE}} {{Akram}},{{Anum}}
{{CMG}} {{shyam}}; {{AE}} {{Akram}}; {{Anum}}; {{FK}}; {{SSH}}


==Overview==
==Overview==
Please see [[Common variable immunodeficiency]]. There are a variety of syndromic conditions related to immunodeficiency. Some syndromic conditions are inherited.


==Classification==
==Classification==
<div style="width: 80%; font-size: 85%;">
{{Family tree/start}}
{{Family tree/start}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | |A01=Combined Immunodeficiency Diseases with associated or syndromic features}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | |A01=Combined Immunodeficiency Diseases with associated or syndromic features}}
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{{Family tree | | | | | | |`| D13 | | | | | | | | | | | | | | | | | | | | | |D13=GINS1 deficiency}}
{{Family tree | | | | | | |`| D13 | | | | | | | | | | | | | | | | | | | | | |D13=GINS1 deficiency}}
{{Family tree/end}}
{{Family tree/end}}
</div>


==Wiskott-Aldrich Syndrome==
==Wiskott-Aldrich Syndrome==
* [[Wiskott-Aldrich syndrome|Wiskott Aldrich syndrome]] (WAS) is X-Linked [[recessive]] primary [[immunodeficiency]] disorder.
* [[Wiskott-Aldrich syndrome|Wiskott Aldrich syndrome]] (WAS) is X-Linked [[recessive]] primary [[immunodeficiency]] disorder.
*The classic triad of Wiskott-Aldrich Syndrome include followings:<ref name="pmid7996359">{{cite journal |vauthors=Sullivan KE, Mullen CA, Blaese RM, Winkelstein JA |title=A multiinstitutional survey of the Wiskott-Aldrich syndrome |journal=J. Pediatr. |volume=125 |issue=6 Pt 1 |pages=876–85 |date=December 1994 |pmid=7996359 |doi= |url=}}</ref>
*The classic triad of Wiskott-Aldrich syndrome include followings:<ref name="pmid7996359">{{cite journal |vauthors=Sullivan KE, Mullen CA, Blaese RM, Winkelstein JA |title=A multiinstitutional survey of the Wiskott-Aldrich syndrome |journal=J. Pediatr. |volume=125 |issue=6 Pt 1 |pages=876–85 |date=December 1994 |pmid=7996359 |doi= |url=}}</ref>
**[[Eczema]]
**[[Eczema]]
**[[Thrombocytopenia]]
**[[Thrombocytopenia]]
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== X-linked thrombocytopenia (XLT) ==
== X-linked thrombocytopenia (XLT) ==
*XLT is a less severe variant of wiskot aldric syndrome.
*X-Liked [[thrombocytopenia]] is a less severe variant of wiskot aldrich syndrome.
* It presents as a benign disease with good long-term survival compared with classic WAS.<ref name="pmid20173115">{{cite journal |vauthors=Albert MH, Bittner TC, Nonoyama S, Notarangelo LD, Burns S, Imai K, Espanol T, Fasth A, Pellier I, Strauss G, Morio T, Gathmann B, Noordzij JG, Fillat C, Hoenig M, Nathrath M, Meindl A, Pagel P, Wintergerst U, Fischer A, Thrasher AJ, Belohradsky BH, Ochs HD |title=X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options |journal=Blood |volume=115 |issue=16 |pages=3231–8 |date=April 2010 |pmid=20173115 |doi=10.1182/blood-2009-09-239087 |url=}}</ref><ref name="pmid28641574">{{cite journal |vauthors=Medina SS, Siqueira LH, Colella MP, Yamaguti-Hayakawa GG, Duarte BKL, Dos Santos Vilela MM, Ozelo MC |title=Intermittent low platelet counts hampering diagnosis of X-linked thrombocytopenia in children: report of two unrelated cases and a novel mutation in the gene coding for the Wiskott-Aldrich syndrome protein |journal=BMC Pediatr |volume=17 |issue=1 |pages=151 |date=June 2017 |pmid=28641574 |pmc=5480256 |doi=10.1186/s12887-017-0897-6 |url=}}</ref><ref name="pmid24115682">{{cite journal |vauthors=Wada T, Itoh M, Maeba H, Toma T, Niida Y, Saikawa Y, Yachie A |title=Intermittent X-linked thrombocytopenia with a novel WAS gene mutation |journal=Pediatr Blood Cancer |volume=61 |issue=4 |pages=746–8 |date=April 2014 |pmid=24115682 |doi=10.1002/pbc.24787 |url=}}</ref>
* X-Liked [[thrombocytopenia]] presents as a benign disease with good long-term survival compared with classic WAS.<ref name="pmid20173115">{{cite journal |vauthors=Albert MH, Bittner TC, Nonoyama S, Notarangelo LD, Burns S, Imai K, Espanol T, Fasth A, Pellier I, Strauss G, Morio T, Gathmann B, Noordzij JG, Fillat C, Hoenig M, Nathrath M, Meindl A, Pagel P, Wintergerst U, Fischer A, Thrasher AJ, Belohradsky BH, Ochs HD |title=X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options |journal=Blood |volume=115 |issue=16 |pages=3231–8 |date=April 2010 |pmid=20173115 |doi=10.1182/blood-2009-09-239087 |url=}}</ref><ref name="pmid28641574">{{cite journal |vauthors=Medina SS, Siqueira LH, Colella MP, Yamaguti-Hayakawa GG, Duarte BKL, Dos Santos Vilela MM, Ozelo MC |title=Intermittent low platelet counts hampering diagnosis of X-linked thrombocytopenia in children: report of two unrelated cases and a novel mutation in the gene coding for the Wiskott-Aldrich syndrome protein |journal=BMC Pediatr |volume=17 |issue=1 |pages=151 |date=June 2017 |pmid=28641574 |pmc=5480256 |doi=10.1186/s12887-017-0897-6 |url=}}</ref><ref name="pmid24115682">{{cite journal |vauthors=Wada T, Itoh M, Maeba H, Toma T, Niida Y, Saikawa Y, Yachie A |title=Intermittent X-linked thrombocytopenia with a novel WAS gene mutation |journal=Pediatr Blood Cancer |volume=61 |issue=4 |pages=746–8 |date=April 2014 |pmid=24115682 |doi=10.1002/pbc.24787 |url=}}</ref>
* There is a relationship between XLT and WAS caused by different type of mutations of the same gene.<ref name="pmid7795648">{{cite journal |vauthors=Villa A, Notarangelo L, Macchi P, Mantuano E, Cavagni G, Brugnoni D, Strina D, Patrosso MC, Ramenghi U, Sacco MG |title=X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with mutations in the WASP gene |journal=Nat. Genet. |volume=9 |issue=4 |pages=414–7 |date=April 1995 |pmid=7795648 |doi=10.1038/ng0495-414 |url=}}</ref>
* There is a relationship between XLT and WAS as both are caused by mutations of the same gene.<ref name="pmid7795648">{{cite journal |vauthors=Villa A, Notarangelo L, Macchi P, Mantuano E, Cavagni G, Brugnoni D, Strina D, Patrosso MC, Ramenghi U, Sacco MG |title=X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with mutations in the WASP gene |journal=Nat. Genet. |volume=9 |issue=4 |pages=414–7 |date=April 1995 |pmid=7795648 |doi=10.1038/ng0495-414 |url=}}</ref>
* WAS gene is mutated in XLT [[Wiskott-Aldrich syndrome protein|Wiskott-Aldrich syndrome]].<ref name="pmid7795648">{{cite journal |vauthors=Villa A, Notarangelo L, Macchi P, Mantuano E, Cavagni G, Brugnoni D, Strina D, Patrosso MC, Ramenghi U, Sacco MG |title=X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with mutations in the WASP gene |journal=Nat. Genet. |volume=9 |issue=4 |pages=414–7 |date=April 1995 |pmid=7795648 |doi=10.1038/ng0495-414 |url=}}</ref>
* WAS gene is mutated in X linked [[thrombocytopenia]] .<ref name="pmid7795648">{{cite journal |vauthors=Villa A, Notarangelo L, Macchi P, Mantuano E, Cavagni G, Brugnoni D, Strina D, Patrosso MC, Ramenghi U, Sacco MG |title=X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with mutations in the WASP gene |journal=Nat. Genet. |volume=9 |issue=4 |pages=414–7 |date=April 1995 |pmid=7795648 |doi=10.1038/ng0495-414 |url=}}</ref>
It usually inherits as a X linked-recessive pattern.
X linked thrombocytopenia is inherited as a [[X linked-recessive|X- linked-recessive pattern.]]
* It is characterized by mild-to-moderate eczema, mild infrequent infections and small-sized platelets.
* X linked thrombocytopenia is characterized by:
**Mild-to-moderate [[eczema]]
**Mild infrequent infections  
**Small-sized platelets
 
* Treatment for patients with XLT is still not determined.<ref name="pmid20173115">{{cite journal |vauthors=Albert MH, Bittner TC, Nonoyama S, Notarangelo LD, Burns S, Imai K, Espanol T, Fasth A, Pellier I, Strauss G, Morio T, Gathmann B, Noordzij JG, Fillat C, Hoenig M, Nathrath M, Meindl A, Pagel P, Wintergerst U, Fischer A, Thrasher AJ, Belohradsky BH, Ochs HD |title=X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options |journal=Blood |volume=115 |issue=16 |pages=3231–8 |date=April 2010 |pmid=20173115 |doi=10.1182/blood-2009-09-239087 |url=}}</ref>
* Treatment for patients with XLT is still not determined.<ref name="pmid20173115">{{cite journal |vauthors=Albert MH, Bittner TC, Nonoyama S, Notarangelo LD, Burns S, Imai K, Espanol T, Fasth A, Pellier I, Strauss G, Morio T, Gathmann B, Noordzij JG, Fillat C, Hoenig M, Nathrath M, Meindl A, Pagel P, Wintergerst U, Fischer A, Thrasher AJ, Belohradsky BH, Ochs HD |title=X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options |journal=Blood |volume=115 |issue=16 |pages=3231–8 |date=April 2010 |pmid=20173115 |doi=10.1182/blood-2009-09-239087 |url=}}</ref>


== WIP Deficiency ==
== WIP Deficiency ==
* The mutation in  WIPF1 gene which is located on chromosome 2q31.1 leads to WIP deficiency.
* WIPF1 gene which is located on chromosome 2q31.1
 
* Mutation of WIPF1 gene leads to WIP deficiency.
 
* WASP is totally complexed with the WASP-interacting protein (WIP).<ref name="pmid3260865">{{cite journal |vauthors=Caputo O, Grosa G, Balliano G, Rocco F, Biglino G |title=In vitro metabolism of 2-(5-ethylpyridin-2-yl)benzimidazole |journal=Eur J Drug Metab Pharmacokinet |volume=13 |issue=1 |pages=47–51 |date=1988 |pmid=3260865 |doi=10.1007/BF03189928 |url=}}</ref>
* WASP is totally complexed with the WASP-interacting protein (WIP).<ref name="pmid3260865">{{cite journal |vauthors=Caputo O, Grosa G, Balliano G, Rocco F, Biglino G |title=In vitro metabolism of 2-(5-ethylpyridin-2-yl)benzimidazole |journal=Eur J Drug Metab Pharmacokinet |volume=13 |issue=1 |pages=47–51 |date=1988 |pmid=3260865 |doi=10.1007/BF03189928 |url=}}</ref>
* Deficiency of WIP leads to [[autosomal recessive]] form of [[Wiskott Aldrich syndrome]].
* Deficiency of WIP leads to [[autosomal recessive]] form of [[Wiskott Aldrich syndrome]].
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* [[Hematopoietic stem cell transplantation]] is the treatment of choice.<ref name="pmid27742395">{{cite journal |vauthors=Al-Mousa H, Hawwari A, Al-Ghonaium A, Al-Saud B, Al-Dhekri H, Al-Muhsen S, Elshorbagi S, Dasouki M, El-Baik L, Alseraihy A, Ayas M, Arnaout R |title=Hematopoietic stem cell transplantation corrects WIP deficiency |journal=J. Allergy Clin. Immunol. |volume=139 |issue=3 |pages=1039–1040.e4 |date=March 2017 |pmid=27742395 |doi=10.1016/j.jaci.2016.08.036 |url=}}</ref>
* [[Hematopoietic stem cell transplantation]] is the treatment of choice.<ref name="pmid27742395">{{cite journal |vauthors=Al-Mousa H, Hawwari A, Al-Ghonaium A, Al-Saud B, Al-Dhekri H, Al-Muhsen S, Elshorbagi S, Dasouki M, El-Baik L, Alseraihy A, Ayas M, Arnaout R |title=Hematopoietic stem cell transplantation corrects WIP deficiency |journal=J. Allergy Clin. Immunol. |volume=139 |issue=3 |pages=1039–1040.e4 |date=March 2017 |pmid=27742395 |doi=10.1016/j.jaci.2016.08.036 |url=}}</ref>


==ARPC1B DEFICIENCY==
==ARPC1B Deficiency==
*It is inherited as an [[autosomal recessive]] disorder.
*ARPC1B is inherited as an [[autosomal recessive]] disorder.
*[[ARPC1B]] also known as actin-related protein 2/3 complex, subunit 1B which is located on 7q22.1.
*[[ARPC1B]] also known as actin-related protein 2/3 complex, subunit 1B which is located on 7q22.1.
*The human complex consists of 7 subunits, including the actin-related proteins ARP2 and ARP3.
*The human complex consists of 7 subunits, including the actin-related proteins ARP2 and ARP3.
* This complex is involved in the control of [[actin]] [[polymerization]] in cells.<ref name="pmid11533442">{{cite journal |vauthors=Volkmann N, Amann KJ, Stoilova-McPhie S, Egile C, Winter DC, Hazelwood L, Heuser JE, Li R, Pollard TD, Hanein D |title=Structure of Arp2/3 complex in its activated state and in actin filament branch junctions |journal=Science |volume=293 |issue=5539 |pages=2456–9 |date=September 2001 |pmid=11533442 |doi=10.1126/science.1063025 |url=}}</ref>
* [[ARPC1B]] complex is involved in the control of [[actin]] [[polymerization]] in cells.<ref name="pmid11533442">{{cite journal |vauthors=Volkmann N, Amann KJ, Stoilova-McPhie S, Egile C, Winter DC, Hazelwood L, Heuser JE, Li R, Pollard TD, Hanein D |title=Structure of Arp2/3 complex in its activated state and in actin filament branch junctions |journal=Science |volume=293 |issue=5539 |pages=2456–9 |date=September 2001 |pmid=11533442 |doi=10.1126/science.1063025 |url=}}</ref>
*Its deficiency leads to [[Platelet abnormalities with eosinophilia and immune-mediated inflammatory disease]].<ref name="KahrPluthero2017">{{cite journal|last1=Kahr|first1=Walter H. A.|last2=Pluthero|first2=Fred G.|last3=Elkadri|first3=Abdul|last4=Warner|first4=Neil|last5=Drobac|first5=Marko|last6=Chen|first6=Chang Hua|last7=Lo|first7=Richard W.|last8=Li|first8=Ling|last9=Li|first9=Ren|last10=Li|first10=Qi|last11=Thoeni|first11=Cornelia|last12=Pan|first12=Jie|last13=Leung|first13=Gabriella|last14=Lara-Corrales|first14=Irene|last15=Murchie|first15=Ryan|last16=Cutz|first16=Ernest|last17=Laxer|first17=Ronald M.|last18=Upton|first18=Julia|last19=Roifman|first19=Chaim M.|last20=Yeung|first20=Rae S. M.|last21=Brumell|first21=John H|last22=Muise|first22=Aleixo M|title=Loss of the Arp2/3 complex component ARPC1B causes platelet abnormalities and predisposes to inflammatory disease|journal=Nature Communications|volume=8|year=2017|pages=14816|issn=2041-1723|doi=10.1038/ncomms14816}}</ref>
*Deficiency of [[ARPC1B]] complex leads to [[platelet abnormalities with eosinophilia and immune-mediated inflammatory disease]].<ref name="KahrPluthero2017">{{cite journal|last1=Kahr|first1=Walter H. A.|last2=Pluthero|first2=Fred G.|last3=Elkadri|first3=Abdul|last4=Warner|first4=Neil|last5=Drobac|first5=Marko|last6=Chen|first6=Chang Hua|last7=Lo|first7=Richard W.|last8=Li|first8=Ling|last9=Li|first9=Ren|last10=Li|first10=Qi|last11=Thoeni|first11=Cornelia|last12=Pan|first12=Jie|last13=Leung|first13=Gabriella|last14=Lara-Corrales|first14=Irene|last15=Murchie|first15=Ryan|last16=Cutz|first16=Ernest|last17=Laxer|first17=Ronald M.|last18=Upton|first18=Julia|last19=Roifman|first19=Chaim M.|last20=Yeung|first20=Rae S. M.|last21=Brumell|first21=John H|last22=Muise|first22=Aleixo M|title=Loss of the Arp2/3 complex component ARPC1B causes platelet abnormalities and predisposes to inflammatory disease|journal=Nature Communications|volume=8|year=2017|pages=14816|issn=2041-1723|doi=10.1038/ncomms14816}}</ref>
*Severe manisfestations of ARPC1B deficiency include followings: <ref name="KuijpersTool2017">{{cite journal|last1=Kuijpers|first1=Taco W.|last2=Tool|first2=Anton T.J.|last3=van der Bijl|first3=Ivo|last4=de Boer|first4=Martin|last5=van Houdt|first5=Michel|last6=de Cuyper|first6=Iris M.|last7=Roos|first7=Dirk|last8=van Alphen|first8=Floris|last9=van Leeuwen|first9=Karin|last10=Cambridge|first10=Emma L.|last11=Arends|first11=Mark J.|last12=Dougan|first12=Gordon|last13=Clare|first13=Simon|last14=Ramirez-Solis|first14=Ramiro|last15=Pals|first15=Steven T.|last16=Adams|first16=David J.|last17=Meijer|first17=Alexander B.|last18=van den Berg|first18=Timo K.|title=Combined immunodeficiency with severe inflammation and allergy caused by ARPC1B deficiency|journal=Journal of Allergy and Clinical Immunology|volume=140|issue=1|year=2017|pages=273–277.e10|issn=00916749|doi=10.1016/j.jaci.2016.09.061}}</ref>
*Severe manisfestations of ARPC1B deficiency include followings: <ref name="KuijpersTool2017">{{cite journal|last1=Kuijpers|first1=Taco W.|last2=Tool|first2=Anton T.J.|last3=van der Bijl|first3=Ivo|last4=de Boer|first4=Martin|last5=van Houdt|first5=Michel|last6=de Cuyper|first6=Iris M.|last7=Roos|first7=Dirk|last8=van Alphen|first8=Floris|last9=van Leeuwen|first9=Karin|last10=Cambridge|first10=Emma L.|last11=Arends|first11=Mark J.|last12=Dougan|first12=Gordon|last13=Clare|first13=Simon|last14=Ramirez-Solis|first14=Ramiro|last15=Pals|first15=Steven T.|last16=Adams|first16=David J.|last17=Meijer|first17=Alexander B.|last18=van den Berg|first18=Timo K.|title=Combined immunodeficiency with severe inflammation and allergy caused by ARPC1B deficiency|journal=Journal of Allergy and Clinical Immunology|volume=140|issue=1|year=2017|pages=273–277.e10|issn=00916749|doi=10.1016/j.jaci.2016.09.061}}</ref>
**[[Recurrent infections]]
**[[Recurrent infections]]
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*Less severe manisfestations include mild [[vasculitis]] and normal numbers of small [[platelets]] without severe infections.
*Less severe manisfestations include mild [[vasculitis]] and normal numbers of small [[platelets]] without severe infections.
*Laboratory studies show [[platelets]] with [[abnormal shape|an abnormal shape]] and decreased [[dense]] [[granules]].
*Laboratory studies show [[platelets]] with [[abnormal shape|an abnormal shape]] and decreased [[dense]] [[granules]].
*Levels of [[eosinophils]], B-[[B-cells|lymphocytes]], [[IgA]] and [[IgE]] are increased due to immune dysregulation.<ref name="pmid28368018">{{cite journal |vauthors=Kahr WH, Pluthero FG, Elkadri A, Warner N, Drobac M, Chen CH, Lo RW, Li L, Li R, Li Q, Thoeni C, Pan J, Leung G, Lara-Corrales I, Murchie R, Cutz E, Laxer RM, Upton J, Roifman CM, Yeung RS, Brumell JH, Muise AM |title=Loss of the Arp2/3 complex component ARPC1B causes platelet abnormalities and predisposes to inflammatory disease |journal=Nat Commun |volume=8 |issue= |pages=14816 |date=April 2017 |pmid=28368018 |pmc=5382316 |doi=10.1038/ncomms14816 |url=}}</ref>
*Levels of [[eosinophils]], B-[[B-cells|lymphocytes]], [[IgA]] and [[IgE]] are increased due to immune dysregulations.<ref name="pmid28368018">{{cite journal |vauthors=Kahr WH, Pluthero FG, Elkadri A, Warner N, Drobac M, Chen CH, Lo RW, Li L, Li R, Li Q, Thoeni C, Pan J, Leung G, Lara-Corrales I, Murchie R, Cutz E, Laxer RM, Upton J, Roifman CM, Yeung RS, Brumell JH, Muise AM |title=Loss of the Arp2/3 complex component ARPC1B causes platelet abnormalities and predisposes to inflammatory disease |journal=Nat Commun |volume=8 |issue= |pages=14816 |date=April 2017 |pmid=28368018 |pmc=5382316 |doi=10.1038/ncomms14816 |url=}}</ref>


==ATAXIA-TELANGIECTASIA==
==Ataxia-telangietectasia==
* Ataxia-telangiectasia (AT) is an [[autosomal recessive]] disorder caused by defective gene in ATM.
* Ataxia-telangiectasia (AT) is an [[autosomal recessive]] disorder caused by defective ATM gene.
* The ATM gene is located on chromosome 11q22.3.
* The ATM gene is located on chromosome 11q22.3.
* It is involved in cell responses to [[DNA damage]] and cell cycle control.<ref name="pmid9143686">{{cite journal |vauthors=Lavin MF, Shiloh Y |title=The genetic defect in ataxia-telangiectasia |journal=Annu. Rev. Immunol. |volume=15 |issue= |pages=177–202 |date=1997 |pmid=9143686 |doi=10.1146/annurev.immunol.15.1.177 |url=}}</ref>
* ATM gene is involved in cell responses to [[DNA damage]] and cell cycle control.<ref name="pmid9143686">{{cite journal |vauthors=Lavin MF, Shiloh Y |title=The genetic defect in ataxia-telangiectasia |journal=Annu. Rev. Immunol. |volume=15 |issue= |pages=177–202 |date=1997 |pmid=9143686 |doi=10.1146/annurev.immunol.15.1.177 |url=}}</ref>
*Common manifestations of AT include followings:<ref name="pmid3200306">{{cite journal |vauthors=Gatti RA, Berkel I, Boder E, Braedt G, Charmley P, Concannon P, Ersoy F, Foroud T, Jaspers NG, Lange K |title=Localization of an ataxia-telangiectasia gene to chromosome 11q22-23 |journal=Nature |volume=336 |issue=6199 |pages=577–80 |date=December 1988 |pmid=3200306 |doi=10.1038/336577a0 |url=}}</ref><ref name="pmid10482258">{{cite journal |vauthors=Lewis RF, Lederman HM, Crawford TO |title=Ocular motor abnormalities in ataxia telangiectasia |journal=Ann. Neurol. |volume=46 |issue=3 |pages=287–95 |date=September 1999 |pmid=10482258 |doi= |url=}}</ref><ref name="pmid20583220">{{cite journal |vauthors=McGrath-Morrow SA, Gower WA, Rothblum-Oviatt C, Brody AS, Langston C, Fan LL, Lefton-Greif MA, Crawford TO, Troche M, Sandlund JT, Auwaerter PG, Easley B, Loughlin GM, Carroll JL, Lederman HM |title=Evaluation and management of pulmonary disease in ataxia-telangiectasia |journal=Pediatr. Pulmonol. |volume=45 |issue=9 |pages=847–59 |date=September 2010 |pmid=20583220 |pmc=4151879 |doi=10.1002/ppul.21277 |url=}}</ref><ref name="pmid23360865">{{cite journal |vauthors=Greenberger S, Berkun Y, Ben-Zeev B, Levi YB, Barziliai A, Nissenkorn A |title=Dermatologic manifestations of ataxia-telangiectasia syndrome |journal=J. Am. Acad. Dermatol. |volume=68 |issue=6 |pages=932–6 |date=June 2013 |pmid=23360865 |doi=10.1016/j.jaad.2012.12.950 |url=}}</ref>
*Common manifestations of AT include followings:<ref name="pmid3200306">{{cite journal |vauthors=Gatti RA, Berkel I, Boder E, Braedt G, Charmley P, Concannon P, Ersoy F, Foroud T, Jaspers NG, Lange K |title=Localization of an ataxia-telangiectasia gene to chromosome 11q22-23 |journal=Nature |volume=336 |issue=6199 |pages=577–80 |date=December 1988 |pmid=3200306 |doi=10.1038/336577a0 |url=}}</ref><ref name="pmid10482258">{{cite journal |vauthors=Lewis RF, Lederman HM, Crawford TO |title=Ocular motor abnormalities in ataxia telangiectasia |journal=Ann. Neurol. |volume=46 |issue=3 |pages=287–95 |date=September 1999 |pmid=10482258 |doi= |url=}}</ref><ref name="pmid20583220">{{cite journal |vauthors=McGrath-Morrow SA, Gower WA, Rothblum-Oviatt C, Brody AS, Langston C, Fan LL, Lefton-Greif MA, Crawford TO, Troche M, Sandlund JT, Auwaerter PG, Easley B, Loughlin GM, Carroll JL, Lederman HM |title=Evaluation and management of pulmonary disease in ataxia-telangiectasia |journal=Pediatr. Pulmonol. |volume=45 |issue=9 |pages=847–59 |date=September 2010 |pmid=20583220 |pmc=4151879 |doi=10.1002/ppul.21277 |url=}}</ref><ref name="pmid23360865">{{cite journal |vauthors=Greenberger S, Berkun Y, Ben-Zeev B, Levi YB, Barziliai A, Nissenkorn A |title=Dermatologic manifestations of ataxia-telangiectasia syndrome |journal=J. Am. Acad. Dermatol. |volume=68 |issue=6 |pages=932–6 |date=June 2013 |pmid=23360865 |doi=10.1016/j.jaad.2012.12.950 |url=}}</ref>
**Neurologic abnormalities
**Neurologic abnormalities
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* Nijmegen breakage syndrome (NBS) is caused by mutation in the [[NBS1]] [[gene]] which is located on [[chromosome]] 8q21.
* Nijmegen breakage syndrome (NBS) is caused by mutation in the [[NBS1]] [[gene]] which is located on [[chromosome]] 8q21.
* It is inherited as an [[autosomal]] [[recessive]] disorder.
* It is inherited as an [[autosomal]] [[recessive]] disorder.
*Common manifestations of NBS include followings:<ref name="pmid22373003">{{cite journal |vauthors=Chrzanowska KH, Gregorek H, Dembowska-Bagińska B, Kalina MA, Digweed M |title=Nijmegen breakage syndrome (NBS) |journal=Orphanet J Rare Dis |volume=7 |issue= |pages=13 |date=February 2012 |pmid=22373003 |pmc=3314554 |doi=10.1186/1750-1172-7-13 |url=}}</ref><ref name="pmid22373003">{{cite journal |vauthors=Chrzanowska KH, Gregorek H, Dembowska-Bagińska B, Kalina MA, Digweed M |title=Nijmegen breakage syndrome (NBS) |journal=Orphanet J Rare Dis |volume=7 |issue= |pages=13 |date=February 2012 |pmid=22373003 |pmc=3314554 |doi=10.1186/1750-1172-7-13 |url=}}</ref><ref name="pmid19105185">{{cite journal |vauthors=Warcoin M, Lespinasse J, Despouy G, Dubois d'Enghien C, Laugé A, Portnoï MF, Christin-Maitre S, Stoppa-Lyonnet D, Stern MH |title=Fertility defects revealing germline biallelic nonsense NBN mutations |journal=Hum. Mutat. |volume=30 |issue=3 |pages=424–30 |date=March 2009 |pmid=19105185 |doi=10.1002/humu.20904 |url=}}</ref><ref name="pmid20444919">{{cite journal |vauthors=Chrzanowska KH, Szarras-Czapnik M, Gajdulewicz M, Kalina MA, Gajtko-Metera M, Walewska-Wolf M, Szufladowicz-Wozniak J, Rysiewski H, Gregorek H, Cukrowska B, Syczewska M, Piekutowska-Abramczuk D, Janas R, Krajewska-Walasek M |title=High prevalence of primary ovarian insufficiency in girls and young women with Nijmegen breakage syndrome: evidence from a longitudinal study |journal=J. Clin. Endocrinol. Metab. |volume=95 |issue=7 |pages=3133–40 |date=July 2010 |pmid=20444919 |doi=10.1210/jc.2009-2628 |url=}}</ref>
*Common manifestations include followings:<ref name="pmid22373003">{{cite journal |vauthors=Chrzanowska KH, Gregorek H, Dembowska-Bagińska B, Kalina MA, Digweed M |title=Nijmegen breakage syndrome (NBS) |journal=Orphanet J Rare Dis |volume=7 |issue= |pages=13 |date=February 2012 |pmid=22373003 |pmc=3314554 |doi=10.1186/1750-1172-7-13 |url=}}</ref><ref name="pmid22373003">{{cite journal |vauthors=Chrzanowska KH, Gregorek H, Dembowska-Bagińska B, Kalina MA, Digweed M |title=Nijmegen breakage syndrome (NBS) |journal=Orphanet J Rare Dis |volume=7 |issue= |pages=13 |date=February 2012 |pmid=22373003 |pmc=3314554 |doi=10.1186/1750-1172-7-13 |url=}}</ref><ref name="pmid19105185">{{cite journal |vauthors=Warcoin M, Lespinasse J, Despouy G, Dubois d'Enghien C, Laugé A, Portnoï MF, Christin-Maitre S, Stoppa-Lyonnet D, Stern MH |title=Fertility defects revealing germline biallelic nonsense NBN mutations |journal=Hum. Mutat. |volume=30 |issue=3 |pages=424–30 |date=March 2009 |pmid=19105185 |doi=10.1002/humu.20904 |url=}}</ref><ref name="pmid20444919">{{cite journal |vauthors=Chrzanowska KH, Szarras-Czapnik M, Gajdulewicz M, Kalina MA, Gajtko-Metera M, Walewska-Wolf M, Szufladowicz-Wozniak J, Rysiewski H, Gregorek H, Cukrowska B, Syczewska M, Piekutowska-Abramczuk D, Janas R, Krajewska-Walasek M |title=High prevalence of primary ovarian insufficiency in girls and young women with Nijmegen breakage syndrome: evidence from a longitudinal study |journal=J. Clin. Endocrinol. Metab. |volume=95 |issue=7 |pages=3133–40 |date=July 2010 |pmid=20444919 |doi=10.1210/jc.2009-2628 |url=}}</ref>
**[[Microcephaly]]
**[[Microcephaly]]
**Dysmorphic facial features
**Dysmorphic facial features
**Mild growth retardation
**Mild [[growth retardation]]
**Mild-to-moderate [[intellectual disability]]
**Mild-to-moderate [[intellectual disability]]
**Café-au-lait spots and depigmented skin lesions
**[[Café-au-lait spots]] and depigmented skin lesions
**Ovarian dysgenesis and premature ovarian failure in females
**[[Ovarian dysgenesis]] and premature [[ovarian failure]] in females
**Hypergonadotropic [[hypogonadism]] and [[infertility]] in males  
**Hypergonadotropic [[hypogonadism]] and [[infertility]] in males  
**Recurrent sinopulmonary infections
**Recurrent [[sinopulmonary]] [[infections]]
**A strong predisposed to development of malignancies of lymphoid origin
* A strong predisposed to development of malignancies of lymphoid origin
* The patients are also [[hypersensitive]] to double stand DNA breaking-inducing agents e.g ionizing radiations.<ref name="pmid18724061">{{cite journal |vauthors=Antoccia A, Kobayashi J, Tauchi H, Matsuura S, Komatsu K |title=Nijmegen breakage syndrome and functions of the responsible protein, NBS1 |journal=Genome Dyn |volume=1 |issue= |pages=191–205 |date=2006 |pmid=18724061 |doi=10.1159/000092508 |url=}}</ref>
* The patients are also [[hypersensitive]] to double stand DNA breaking-inducing agents e.g ionizing [[radiations]].<ref name="pmid18724061">{{cite journal |vauthors=Antoccia A, Kobayashi J, Tauchi H, Matsuura S, Komatsu K |title=Nijmegen breakage syndrome and functions of the responsible protein, NBS1 |journal=Genome Dyn |volume=1 |issue= |pages=191–205 |date=2006 |pmid=18724061 |doi=10.1159/000092508 |url=}}</ref>
* There is no specific treatment for NBS.
* There is no specific treatment for NBS.


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* Bloom Syndrome is inherited as an [[autosomal recessive]] inherited disorder.
* Bloom Syndrome is inherited as an [[autosomal recessive]] inherited disorder.
* Most common manifestations of Bloom syndrome include followings:<ref name="pmid20973772">{{cite journal |vauthors=Karalis A, Tischkowitz M, Millington GW |title=Dermatological manifestations of inherited cancer syndromes in children |journal=Br. J. Dermatol. |volume=164 |issue=2 |pages=245–56 |date=February 2011 |pmid=20973772 |doi=10.1111/j.1365-2133.2010.10100.x |url=}}</ref><ref name="pmid8875252">{{cite journal |vauthors=Ellis NA, German J |title=Molecular genetics of Bloom's syndrome |journal=Hum. Mol. Genet. |volume=5 Spec No |issue= |pages=1457–63 |date=1996 |pmid=8875252 |doi= |url=}}</ref>
* Most common manifestations of Bloom syndrome include followings:<ref name="pmid20973772">{{cite journal |vauthors=Karalis A, Tischkowitz M, Millington GW |title=Dermatological manifestations of inherited cancer syndromes in children |journal=Br. J. Dermatol. |volume=164 |issue=2 |pages=245–56 |date=February 2011 |pmid=20973772 |doi=10.1111/j.1365-2133.2010.10100.x |url=}}</ref><ref name="pmid8875252">{{cite journal |vauthors=Ellis NA, German J |title=Molecular genetics of Bloom's syndrome |journal=Hum. Mol. Genet. |volume=5 Spec No |issue= |pages=1457–63 |date=1996 |pmid=8875252 |doi= |url=}}</ref>
**Growth deficiency of prenatal onset
**[[Growth]] deficiency of prenatal onset
**[[Immunodeficiency]]
**[[Immunodeficiency]]
**[[Café-au-lait spot|Café-au-lait]] spots or [[Hypopigmentation|hypopigmented]] skin lesions
**[[Café-au-lait spot|Café-au-lait]] spots or [[Hypopigmentation|hypopigmented]] skin lesions
Line 154: Line 161:
**[[Type 2 diabetes mellitus]]
**[[Type 2 diabetes mellitus]]
**[[Hypogonadism]]
**[[Hypogonadism]]
**Predisposition to the development of all types of cancers
**Predisposition to the development of all types of [[cancers]]
* Bloom syndrome is diagnosed by detecting mutations in BLM gene.<ref name="pmid18471088">{{cite journal |vauthors=Amor-Guéret M, Dubois-d'Enghien C, Laugé A, Onclercq-Delic R, Barakat A, Chadli E, Bousfiha AA, Benjelloun M, Flori E, Doray B, Laugel V, Lourenço MT, Gonçalves R, Sousa S, Couturier J, Stoppa-Lyonnet D |title=Three new BLM gene mutations associated with Bloom syndrome |journal=Genet. Test. |volume=12 |issue=2 |pages=257–61 |date=June 2008 |pmid=18471088 |doi=10.1089/gte.2007.0119 |url=}}</ref>
* Bloom syndrome is diagnosed by detecting mutations in BLM gene.<ref name="pmid18471088">{{cite journal |vauthors=Amor-Guéret M, Dubois-d'Enghien C, Laugé A, Onclercq-Delic R, Barakat A, Chadli E, Bousfiha AA, Benjelloun M, Flori E, Doray B, Laugel V, Lourenço MT, Gonçalves R, Sousa S, Couturier J, Stoppa-Lyonnet D |title=Three new BLM gene mutations associated with Bloom syndrome |journal=Genet. Test. |volume=12 |issue=2 |pages=257–61 |date=June 2008 |pmid=18471088 |doi=10.1089/gte.2007.0119 |url=}}</ref>
*There is no specific treatment for bloom syndrome.
*There is no specific treatment for bloom syndrome.
Line 160: Line 167:
==PMS2 Deficiency==
==PMS2 Deficiency==
* PMS2 also known as Post-Meiotic Segregation 2.
* PMS2 also known as Post-Meiotic Segregation 2.
* PMS2 gene is located on chromosome 7p22.1 and encodes for DNA repair proteins which are involved in DNA mismatch repair.<ref name="pmid7172481">{{cite journal |vauthors=Michels VV, Stevens JC |title=Basal cell carcinoma in a patient with intestinal polyposis |journal=Clin. Genet. |volume=22 |issue=2 |pages=80–2 |date=August 1982 |pmid=7172481 |doi= |url=}}</ref>
 
* It is inherited as [[autosomal recessive]] pattern.<ref name="pmid24737826">{{cite journal |vauthors=Wimmer K, Kratz CP, Vasen HF, Caron O, Colas C, Entz-Werle N, Gerdes AM, Goldberg Y, Ilencikova D, Muleris M, Duval A, Lavoine N, Ruiz-Ponte C, Slavc I, Burkhardt B, Brugieres L |title=Diagnostic criteria for constitutional mismatch repair deficiency syndrome: suggestions of the European consortium 'care for CMMRD' (C4CMMRD) |journal=J. Med. Genet. |volume=51 |issue=6 |pages=355–65 |date=June 2014 |pmid=24737826 |doi=10.1136/jmedgenet-2014-102284 |url=}}</ref>
* PMS2 gene is located on [[chromosome]] 7p22.1
* Deficency of PMS2 increased the risk of [[colorectal cancer]] and hereditary nonpolyposis.<ref name="pmid8072530">{{cite journal |vauthors=Nicolaides NC, Papadopoulos N, Liu B, Wei YF, Carter KC, Ruben SM, Rosen CA, Haseltine WA, Fleischmann RD, Fraser CM |title=Mutations of two PMS homologues in hereditary nonpolyposis colon cancer |journal=Nature |volume=371 |issue=6492 |pages=75–80 |date=September 1994 |pmid=8072530 |doi=10.1038/371075a0 |url=}}</ref>
 
* PMS2 gene  encodes for [[DNA]] [[repair]] [[proteins]] which are involved in DNA [[mismatch repair]].<ref name="pmid7172481">{{cite journal |vauthors=Michels VV, Stevens JC |title=Basal cell carcinoma in a patient with intestinal polyposis |journal=Clin. Genet. |volume=22 |issue=2 |pages=80–2 |date=August 1982 |pmid=7172481 |doi= |url=}}</ref>
 
* PMS2 Deficiency is inherited as [[autosomal recessive]] pattern.<ref name="pmid24737826">{{cite journal |vauthors=Wimmer K, Kratz CP, Vasen HF, Caron O, Colas C, Entz-Werle N, Gerdes AM, Goldberg Y, Ilencikova D, Muleris M, Duval A, Lavoine N, Ruiz-Ponte C, Slavc I, Burkhardt B, Brugieres L |title=Diagnostic criteria for constitutional mismatch repair deficiency syndrome: suggestions of the European consortium 'care for CMMRD' (C4CMMRD) |journal=J. Med. Genet. |volume=51 |issue=6 |pages=355–65 |date=June 2014 |pmid=24737826 |doi=10.1136/jmedgenet-2014-102284 |url=}}</ref>
* Deficiency of PMS2 increases the risk of [[colorectal cancer]] and [[Hereditary nonpolyposis colorectal cancer (patient information)|hereditary nonpolyposis]].<ref name="pmid8072530">{{cite journal |vauthors=Nicolaides NC, Papadopoulos N, Liu B, Wei YF, Carter KC, Ruben SM, Rosen CA, Haseltine WA, Fleischmann RD, Fraser CM |title=Mutations of two PMS homologues in hereditary nonpolyposis colon cancer |journal=Nature |volume=371 |issue=6492 |pages=75–80 |date=September 1994 |pmid=8072530 |doi=10.1038/371075a0 |url=}}</ref>


== Immunodeficiency with Centromeric instability and Facial anomalies(ICF1, ICF2, ICF3, ICF4) ==
== Immunodeficiency with Centromeric instability and Facial anomalies(ICF1, ICF2, ICF3, ICF4) ==
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**[[Immunodeficiency]]
**[[Immunodeficiency]]
**[[facial dysmorphism]]
**[[facial dysmorphism]]
***Ocular hypertelorism
***[[Ocular hypertelorism]]
***Flat nasal bridge  
***[[Flat nasal bridge]]
***Epicanthal fold
***[[Epicanthal folds|Epicanthal fold]]
***Low-set ears
***[[Low-set ears]]
**[[Growth retardation]]
**[[Growth retardation]]
**[[Failure to thrive]]
**[[Failure to thrive]]
**[[Psychomotor retardation]]
**[[Psychomotor retardation]]
* The presenting symptom are recurrent infections usually in early childhood.
* The presenting symptom is recurrent infections usually in early childhood.
* At least two [[immunoglobulin]] classes are affected in each patient, and [[agammaglobulinemia]] can occur.
* At least two [[immunoglobulin]] classes are affected in each patient and [[agammaglobulinemia]] can occur.
* [[T cell]] number and response to [[mitogen]] may be decreased.<ref name="pmid8076938">{{cite journal |vauthors=Smeets DF, Moog U, Weemaes CM, Vaes-Peeters G, Merkx GF, Niehof JP, Hamers G |title=ICF syndrome: a new case and review of the literature |journal=Hum. Genet. |volume=94 |issue=3 |pages=240–6 |date=September 1994 |pmid=8076938 |doi= |url=}}</ref><ref name="pmid2386052">{{cite journal |vauthors=Fasth A, Forestier E, Holmberg E, Holmgren G, Nordenson I, Söderström T, Wahlström J |title=Fragility of the centromeric region of chromosome 1 associated with combined immunodeficiency in siblings. A recessively inherited entity? |journal=Acta Paediatr Scand |volume=79 |issue=6-7 |pages=605–12 |date=1990 |pmid=2386052 |doi= |url=}}</ref><ref name="pmid3351904">{{cite journal |vauthors=Maraschio P, Zuffardi O, Dalla Fior T, Tiepolo L |title=Immunodeficiency, centromeric heterochromatin instability of chromosomes 1, 9, and 16, and facial anomalies: the ICF syndrome |journal=J. Med. Genet. |volume=25 |issue=3 |pages=173–80 |date=March 1988 |pmid=3351904 |pmc=1015482 |doi= |url=}}</ref>
* [[T cell]] number and response to [[mitogen]] may be decreased.<ref name="pmid8076938">{{cite journal |vauthors=Smeets DF, Moog U, Weemaes CM, Vaes-Peeters G, Merkx GF, Niehof JP, Hamers G |title=ICF syndrome: a new case and review of the literature |journal=Hum. Genet. |volume=94 |issue=3 |pages=240–6 |date=September 1994 |pmid=8076938 |doi= |url=}}</ref><ref name="pmid2386052">{{cite journal |vauthors=Fasth A, Forestier E, Holmberg E, Holmgren G, Nordenson I, Söderström T, Wahlström J |title=Fragility of the centromeric region of chromosome 1 associated with combined immunodeficiency in siblings. A recessively inherited entity? |journal=Acta Paediatr Scand |volume=79 |issue=6-7 |pages=605–12 |date=1990 |pmid=2386052 |doi= |url=}}</ref><ref name="pmid3351904">{{cite journal |vauthors=Maraschio P, Zuffardi O, Dalla Fior T, Tiepolo L |title=Immunodeficiency, centromeric heterochromatin instability of chromosomes 1, 9, and 16, and facial anomalies: the ICF syndrome |journal=J. Med. Genet. |volume=25 |issue=3 |pages=173–80 |date=March 1988 |pmid=3351904 |pmc=1015482 |doi= |url=}}</ref>
* The [[centromeric]] instability most frequently involves chromosomes 1 and 16, often 9, and rarely 2 and 10.
* The [[centromeric]] instability most frequently involves chromosomes 1 and 16, often 9, and rarely 2 and 10.
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==MCM4 Deficiency==
==MCM4 Deficiency==
* MCM also known as [[minichromosome]] maintenance complex component 4.
* MCM stands for [[minichromosome]] maintenance complex component 4. MCM4 is one part of a MCM2-7 complex which functions as the replicative [[helicase]] which is essential for normal [[DNA]] replication and [[genome]] stability.
* Deficiency is caused by [[homozygous]] mutation in the MCM4 gene located on 8q11.21. <ref name="pmid3287227">{{cite journal |vauthors=Villa A, Sinchetto F, Lanfranconi M |title=[Pathology of the myocardium and coronary vessels in sudden cardiac death. A post-mortem study of 130 cases] |language=Italian |journal=Minerva Med. |volume=79 |issue=5 |pages=373–8 |date=May 1988 |pmid=3287227 |doi= |url=}}</ref>
* MCM4 deficiency is caused by [[mutation]] in the MCM4 [[gene]] located on 8q11.21. <ref name="pmid3287227">{{cite journal |vauthors=Villa A, Sinchetto F, Lanfranconi M |title=[Pathology of the myocardium and coronary vessels in sudden cardiac death. A post-mortem study of 130 cases] |language=Italian |journal=Minerva Med. |volume=79 |issue=5 |pages=373–8 |date=May 1988 |pmid=3287227 |doi= |url=}}</ref>
* MCM4 Deficiency is a variant of familial [[glucocorticoid]] deficiency (FGD), an [[autosomal recessive]] form of adrenal failure.<ref name="pmid16532402">{{cite journal |vauthors=Eidenschenk C, Dunne J, Jouanguy E, Fourlinnie C, Gineau L, Bacq D, McMahon C, Smith O, Casanova JL, Abel L, Feighery C |title=A novel primary immunodeficiency with specific natural-killer cell deficiency maps to the centromeric region of chromosome 8 |journal=Am. J. Hum. Genet. |volume=78 |issue=4 |pages=721–7 |date=April 2006 |pmid=16532402 |pmc=1424699 |doi=10.1086/503269 |url=}}</ref>
* MCM4 deficiency is characterized by:<ref name="pmid22354167">{{cite journal |vauthors=Gineau L, Cognet C, Kara N, Lach FP, Dunne J, Veturi U, Picard C, Trouillet C, Eidenschenk C, Aoufouchi S, Alcaïs A, Smith O, Geissmann F, Feighery C, Abel L, Smogorzewska A, Stillman B, Vivier E, Casanova JL, Jouanguy E |title=Partial MCM4 deficiency in patients with growth retardation, adrenal insufficiency, and natural killer cell deficiency |journal=J. Clin. Invest. |volume=122 |issue=3 |pages=821–32 |date=March 2012 |pmid=22354167 |pmc=3287233 |doi=10.1172/JCI61014 |url=}}</ref>
* MCM4 is one part of a MCM2-7 complex which functions as the replicative helicase that  is essential for normal DNA replication and genome stability in all eukaryotes.
**[[Short stature]]
* It characterized by short stature, [[adrenal insufficiency]] and [[NK cell deficiency]].<ref name="pmid22354167">{{cite journal |vauthors=Gineau L, Cognet C, Kara N, Lach FP, Dunne J, Veturi U, Picard C, Trouillet C, Eidenschenk C, Aoufouchi S, Alcaïs A, Smith O, Geissmann F, Feighery C, Abel L, Smogorzewska A, Stillman B, Vivier E, Casanova JL, Jouanguy E |title=Partial MCM4 deficiency in patients with growth retardation, adrenal insufficiency, and natural killer cell deficiency |journal=J. Clin. Invest. |volume=122 |issue=3 |pages=821–32 |date=March 2012 |pmid=22354167 |pmc=3287233 |doi=10.1172/JCI61014 |url=}}</ref>
**[[Adrenal insufficiency]]
* Recurrent viral illnesses can occur due to [[NK cell deficiency]].<ref name="pmid22499342">{{cite journal |vauthors=Casey JP, Nobbs M, McGettigan P, Lynch S, Ennis S |title=Recessive mutations in MCM4/PRKDC cause a novel syndrome involving a primary immunodeficiency and a disorder of DNA repair |journal=J. Med. Genet. |volume=49 |issue=4 |pages=242–5 |date=April 2012 |pmid=22499342 |doi=10.1136/jmedgenet-2012-100803 |url=}}</ref><ref name="pmid16532402">{{cite journal |vauthors=Eidenschenk C, Dunne J, Jouanguy E, Fourlinnie C, Gineau L, Bacq D, McMahon C, Smith O, Casanova JL, Abel L, Feighery C |title=A novel primary immunodeficiency with specific natural-killer cell deficiency maps to the centromeric region of chromosome 8 |journal=Am. J. Hum. Genet. |volume=78 |issue=4 |pages=721–7 |date=April 2006 |pmid=16532402 |pmc=1424699 |doi=10.1086/503269 |url=}}</ref>
**[[NK cell deficiency]] which leads to recurrent [[viral]] illnesses<ref name="pmid22499342">{{cite journal |vauthors=Casey JP, Nobbs M, McGettigan P, Lynch S, Ennis S |title=Recessive mutations in MCM4/PRKDC cause a novel syndrome involving a primary immunodeficiency and a disorder of DNA repair |journal=J. Med. Genet. |volume=49 |issue=4 |pages=242–5 |date=April 2012 |pmid=22499342 |doi=10.1136/jmedgenet-2012-100803 |url=}}</ref><ref name="pmid16532402">{{cite journal |vauthors=Eidenschenk C, Dunne J, Jouanguy E, Fourlinnie C, Gineau L, Bacq D, McMahon C, Smith O, Casanova JL, Abel L, Feighery C |title=A novel primary immunodeficiency with specific natural-killer cell deficiency maps to the centromeric region of chromosome 8 |journal=Am. J. Hum. Genet. |volume=78 |issue=4 |pages=721–7 |date=April 2006 |pmid=16532402 |pmc=1424699 |doi=10.1086/503269 |url=}}</ref>
* It has biochemical features of familial [[glucocorticoid]] deficiency, with isolated [[glucocorticoid]] deficiency, increased [[ACTH]], and normal [[aldosterone]] and [[renin]] levels.
* MCM4 deficiency is a variant of familial [[glucocorticoid]] deficiency (FGD), an [[autosomal recessive]] form of adrenal failure.<ref name="pmid16532402" />
* MCM4 deficiency shares biochemical features of familial [[glucocorticoid]] deficiency, with isolated [[glucocorticoid]] deficiency, increased [[ACTH]], and normal [[aldosterone]] and [[renin]] levels.
* Individuals with [[adrenal insufficiency]] should be given [[corticosteroid]] replacement therapy.
* Individuals with [[adrenal insufficiency]] should be given [[corticosteroid]] replacement therapy.


Line 201: Line 213:
* RNF168 stands for Ring finger protein 168(RNF168).
* RNF168 stands for Ring finger protein 168(RNF168).
* RNF168 gene is located on chromosome 3q29.<ref name="pmid21394101">{{cite journal |vauthors=Devgan SS, Sanal O, Doil C, Nakamura K, Nahas SA, Pettijohn K, Bartek J, Lukas C, Lukas J, Gatti RA |title=Homozygous deficiency of ubiquitin-ligase ring-finger protein RNF168 mimics the radiosensitivity syndrome of ataxia-telangiectasia |journal=Cell Death Differ. |volume=18 |issue=9 |pages=1500–6 |date=September 2011 |pmid=21394101 |pmc=3178430 |doi=10.1038/cdd.2011.18 |url=}}</ref>
* RNF168 gene is located on chromosome 3q29.<ref name="pmid21394101">{{cite journal |vauthors=Devgan SS, Sanal O, Doil C, Nakamura K, Nahas SA, Pettijohn K, Bartek J, Lukas C, Lukas J, Gatti RA |title=Homozygous deficiency of ubiquitin-ligase ring-finger protein RNF168 mimics the radiosensitivity syndrome of ataxia-telangiectasia |journal=Cell Death Differ. |volume=18 |issue=9 |pages=1500–6 |date=September 2011 |pmid=21394101 |pmc=3178430 |doi=10.1038/cdd.2011.18 |url=}}</ref>
* RNF168 gene encodes E3 ubiquitin ligase which is involved in repair of double strand DNA breaks.<ref name="pmid19203578">{{cite journal |vauthors=Stewart GS, Panier S, Townsend K, Al-Hakim AK, Kolas NK, Miller ES, Nakada S, Ylanko J, Olivarius S, Mendez M, Oldreive C, Wildenhain J, Tagliaferro A, Pelletier L, Taubenheim N, Durandy A, Byrd PJ, Stankovic T, Taylor AM, Durocher D |title=The RIDDLE syndrome protein mediates a ubiquitin-dependent signaling cascade at sites of DNA damage |journal=Cell |volume=136 |issue=3 |pages=420–34 |date=February 2009 |pmid=19203578 |doi=10.1016/j.cell.2008.12.042 |url=}}</ref>
* RNF168 gene encodes E3 ubiquitin ligase which is involved in repair of double strand [[DNA]] breaks.<ref name="pmid19203578">{{cite journal |vauthors=Stewart GS, Panier S, Townsend K, Al-Hakim AK, Kolas NK, Miller ES, Nakada S, Ylanko J, Olivarius S, Mendez M, Oldreive C, Wildenhain J, Tagliaferro A, Pelletier L, Taubenheim N, Durandy A, Byrd PJ, Stankovic T, Taylor AM, Durocher D |title=The RIDDLE syndrome protein mediates a ubiquitin-dependent signaling cascade at sites of DNA damage |journal=Cell |volume=136 |issue=3 |pages=420–34 |date=February 2009 |pmid=19203578 |doi=10.1016/j.cell.2008.12.042 |url=}}</ref>
* Mutation of this gene leads to RIDDLE syndrome.<ref name="pmid17940005">{{cite journal |vauthors=Stewart GS, Stankovic T, Byrd PJ, Wechsler T, Miller ES, Huissoon A, Drayson MT, West SC, Elledge SJ, Taylor AM |title=RIDDLE immunodeficiency syndrome is linked to defects in 53BP1-mediated DNA damage signaling |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=43 |pages=16910–5 |date=October 2007 |pmid=17940005 |pmc=2040433 |doi=10.1073/pnas.0708408104 |url=}}</ref>
* Mutation of RNF168 gene leads to RIDDLE syndrome which is inherited as an [[autosomal]] [[recessive]] pattern.<ref name="pmid17940005">{{cite journal |vauthors=Stewart GS, Stankovic T, Byrd PJ, Wechsler T, Miller ES, Huissoon A, Drayson MT, West SC, Elledge SJ, Taylor AM |title=RIDDLE immunodeficiency syndrome is linked to defects in 53BP1-mediated DNA damage signaling |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=43 |pages=16910–5 |date=October 2007 |pmid=17940005 |pmc=2040433 |doi=10.1073/pnas.0708408104 |url=}}</ref>
* RIDDLE syndrome is inherited as an autosomal recessive pattern.
* RIDDLE syndrome is characterized by:<ref name="pmid17940005">{{cite journal |vauthors=Stewart GS, Stankovic T, Byrd PJ, Wechsler T, Miller ES, Huissoon A, Drayson MT, West SC, Elledge SJ, Taylor AM |title=RIDDLE immunodeficiency syndrome is linked to defects in 53BP1-mediated DNA damage signaling |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=43 |pages=16910–5 |date=October 2007 |pmid=17940005 |pmc=2040433 |doi=10.1073/pnas.0708408104 |url=}}</ref>
* RIDDLE syndrome is characterized by
**[[Radio-sensitivity]]
**Radio-sensitivity
**[[Immunodeficiency]]
**Immunodeficiency
**Dysmorphic features
**Dysmorphic features
**Learning difficulties<ref name="pmid17940005">{{cite journal |vauthors=Stewart GS, Stankovic T, Byrd PJ, Wechsler T, Miller ES, Huissoon A, Drayson MT, West SC, Elledge SJ, Taylor AM |title=RIDDLE immunodeficiency syndrome is linked to defects in 53BP1-mediated DNA damage signaling |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=43 |pages=16910–5 |date=October 2007 |pmid=17940005 |pmc=2040433 |doi=10.1073/pnas.0708408104 |url=}}</ref>
**[[Learning difficulties]]
* It is pathologicaly similar to the ataxia-telangiectasia syndrome.<ref name="pmid19203578">{{cite journal |vauthors=Stewart GS, Panier S, Townsend K, Al-Hakim AK, Kolas NK, Miller ES, Nakada S, Ylanko J, Olivarius S, Mendez M, Oldreive C, Wildenhain J, Tagliaferro A, Pelletier L, Taubenheim N, Durandy A, Byrd PJ, Stankovic T, Taylor AM, Durocher D |title=The RIDDLE syndrome protein mediates a ubiquitin-dependent signaling cascade at sites of DNA damage |journal=Cell |volume=136 |issue=3 |pages=420–34 |date=February 2009 |pmid=19203578 |doi=10.1016/j.cell.2008.12.042 |url=}}</ref>
**[[Short stature]]
* Non immunological manifestation include including short stature and motor control problems.
**Motor control problems
* It is pathologically similar to the [[Ataxia telangiectasia|ataxia-telangiectasia syndrome]].<ref name="pmid19203578">{{cite journal |vauthors=Stewart GS, Panier S, Townsend K, Al-Hakim AK, Kolas NK, Miller ES, Nakada S, Ylanko J, Olivarius S, Mendez M, Oldreive C, Wildenhain J, Tagliaferro A, Pelletier L, Taubenheim N, Durandy A, Byrd PJ, Stankovic T, Taylor AM, Durocher D |title=The RIDDLE syndrome protein mediates a ubiquitin-dependent signaling cascade at sites of DNA damage |journal=Cell |volume=136 |issue=3 |pages=420–34 |date=February 2009 |pmid=19203578 |doi=10.1016/j.cell.2008.12.042 |url=}}</ref>


==POLE1 Deficiency==
==POLE1 deficiency==
* POLE1 stands for DNA polymerase,epsilon subunit 1.
* POLE1 stands for DNA polymerase, epsilon subunit 1.
* The POLE1 gene is located on 12q24.33.
* The POLE1 gene is located on chromosome 12q24.33.
* POLE1 gene encodes the catalytic subunit of DNA polymerase epsilon.
* POLE1 gene encodes the catalytic subunit of DNA polymerase epsilon.
* It is inherited as an autosomal recessive pattern.
* POLE1 deficiency is inherited as an [[autosomal recessive]] pattern.
* Mutation in the POLE1 leads to FILS syndrome
* Mutation in the POLE1 leads to FILS syndrome.
* It is characterized by
* The age of onset of FILS syndrome is less than 40 years.<ref name="pmid23263490">{{cite journal |vauthors=Palles C, Cazier JB, Howarth KM, Domingo E, Jones AM, Broderick P, Kemp Z, Spain SL, Guarino E, Guarino Almeida E, Salguero I, Sherborne A, Chubb D, Carvajal-Carmona LG, Ma Y, Kaur K, Dobbins S, Barclay E, Gorman M, Martin L, Kovac MB, Humphray S, Lucassen A, Holmes CC, Bentley D, Donnelly P, Taylor J, Petridis C, Roylance R, Sawyer EJ, Kerr DJ, Clark S, Grimes J, Kearsey SE, Thomas HJ, McVean G, Houlston RS, Tomlinson I |title=Germline mutations affecting the proofreading domains of POLE and POLD1 predispose to colorectal adenomas and carcinomas |journal=Nat. Genet. |volume=45 |issue=2 |pages=136–44 |date=February 2013 |pmid=23263490 |pmc=3785128 |doi=10.1038/ng.2503 |url=}}</ref>
**Facial dysmorphism
* It is characterized by:
**Immunodeficiency
**Facial [[dysmorphism]]
**[[Immunodeficiencies]]
**Livedo on the skin since birth
**Livedo on the skin since birth
**Short stature syndrome<ref name="pmid3526359">{{cite journal |vauthors=Tamaro M, Dolzani L, Monti-Bragadin C, Sava G |title=Mutagenic activity of the dacarbazine analog p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt in bacterial cells |journal=Pharmacol Res Commun |volume=18 |issue=5 |pages=491–501 |date=May 1986 |pmid=3526359 |doi= |url=}}</ref>
**[[Short stature]]<ref name="pmid3526359">{{cite journal |vauthors=Tamaro M, Dolzani L, Monti-Bragadin C, Sava G |title=Mutagenic activity of the dacarbazine analog p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt in bacterial cells |journal=Pharmacol Res Commun |volume=18 |issue=5 |pages=491–501 |date=May 1986 |pmid=3526359 |doi= |url=}}</ref><ref name="pmid23230001">{{cite journal |vauthors=Pachlopnik Schmid J, Lemoine R, Nehme N, Cormier-Daire V, Revy P, Debeurme F, Debré M, Nitschke P, Bole-Feysot C, Legeai-Mallet L, Lim A, de Villartay JP, Picard C, Durandy A, Fischer A, de Saint Basile G |title=Polymerase ε1 mutation in a human syndrome with facial dysmorphism, immunodeficiency, livedo, and short [[stature]] ("FILS syndrome") |journal=J. Exp. Med. |volume=209 |issue=13 |pages=2323–30 |date=December 2012 |pmid=23230001 |pmc=3526359 |doi=10.1084/jem.20121303 |url=}}</ref>
* FILS syndrome is characterized by mild facial dysmorphism, mainly malar hypoplasia, livedo on the skin since birth, immunodeficiency resulting in recurrent infections, and short stature<ref name="pmid23230001">{{cite journal |vauthors=Pachlopnik Schmid J, Lemoine R, Nehme N, Cormier-Daire V, Revy P, Debeurme F, Debré M, Nitschke P, Bole-Feysot C, Legeai-Mallet L, Lim A, de Villartay JP, Picard C, Durandy A, Fischer A, de Saint Basile G |title=Polymerase ε1 mutation in a human syndrome with facial dysmorphism, immunodeficiency, livedo, and short stature ("FILS syndrome") |journal=J. Exp. Med. |volume=209 |issue=13 |pages=2323–30 |date=December 2012 |pmid=23230001 |pmc=3526359 |doi=10.1084/jem.20121303 |url=}}</ref>
* If the mutation in [[POLE1 gene]] is inherited as an [[Dominant disease|autosomal dominant]] pattern, it leads to [[colorectal cancer]]-12 which is characterized by a high predisposition of [[colorectal]] [[adenomas]] and [[carcinomas]].
* If the mutation is inherited as an Autosomal Dominant pattern it leads to Colorectal cancer-12.
* Colorectal cancer-12 is characterized by a high predisposition of colorectal adenomas and carcinomas.
* Onset is less than 40 years.<ref name="pmid23263490">{{cite journal |vauthors=Palles C, Cazier JB, Howarth KM, Domingo E, Jones AM, Broderick P, Kemp Z, Spain SL, Guarino E, Guarino Almeida E, Salguero I, Sherborne A, Chubb D, Carvajal-Carmona LG, Ma Y, Kaur K, Dobbins S, Barclay E, Gorman M, Martin L, Kovac MB, Humphray S, Lucassen A, Holmes CC, Bentley D, Donnelly P, Taylor J, Petridis C, Roylance R, Sawyer EJ, Kerr DJ, Clark S, Grimes J, Kearsey SE, Thomas HJ, McVean G, Houlston RS, Tomlinson I |title=Germline mutations affecting the proofreading domains of POLE and POLD1 predispose to colorectal adenomas and carcinomas |journal=Nat. Genet. |volume=45 |issue=2 |pages=136–44 |date=February 2013 |pmid=23263490 |pmc=3785128 |doi=10.1038/ng.2503 |url=}}</ref>


==POLE2 Deficiency==
==POLE2 deficiency==
* POLE2 stands for DNA polymerase epsilon subunit 2.<ref name="pmid9405441">{{cite journal |vauthors=Li Y, Asahara H, Patel VS, Zhou S, Linn S |title=Purification, cDNA cloning, and gene mapping of the small subunit of human DNA polymerase epsilon |journal=J. Biol. Chem. |volume=272 |issue=51 |pages=32337–44 |date=December 1997 |pmid=9405441 |doi= |url=}}</ref>
* POLE2 stands for DNA polymerase epsilon subunit 2.<ref name="pmid9405441">{{cite journal |vauthors=Li Y, Asahara H, Patel VS, Zhou S, Linn S |title=Purification, cDNA cloning, and gene mapping of the small subunit of human DNA polymerase epsilon |journal=J. Biol. Chem. |volume=272 |issue=51 |pages=32337–44 |date=December 1997 |pmid=9405441 |doi= |url=}}</ref>
* This gene is located on 14q21.
* POLE2 gene is located on choromosome 14q21.
* It is involved in both DNA replication and DNA repair.
* POLE2 is involved in both [[DNA]] [[replication]] and [[DNA]] repair.
* Mutation in the POLE2 gene causes combined Immunodeficiency.
* POLE2 deficiency is inherited as an [[autosomal recessive]] pattern.
* It is inherited as an autosomal recessive pattern.
* POLE2 deficiency is characterized by the followings:
* It is characterized by
**Combined [[immunodeficiencies]]
**Combined immunodeficiency
**[[Facial dysmorphism]]
**Facial dysmorphism
**[[Autoimmunity]]<ref name="pmid4747780">{{cite journal |vauthors=Miller MJ |title=Industrialization, ecology and health in the tropics |journal=Can J Public Health |volume=64 |issue= |pages=Suppl: 11–6 |date=October 1973 |pmid=4747780 |doi= |url=}}</ref>
**Autoimmunity<ref name="pmid4747780">{{cite journal |vauthors=Miller MJ |title=Industrialization, ecology and health in the tropics |journal=Can J Public Health |volume=64 |issue= |pages=Suppl: 11–6 |date=October 1973 |pmid=4747780 |doi= |url=}}</ref>


==NSMCE3 Deficiency==
==NSMCE3 Deficiency==
* NSMCE3 stands for non structural maintainence of chromosomes element 3.
* NSMCE3 stands for non structural maintenance of chromosomes element 3.
* The NSMCE3 gene encodes a component of the SMC5/SMC6complex.
* NSMCE3 [[gene]] is located on chromosome 15q13.1.
* This complex is important for responses to [[DNA]] damage and [[chromosome]] [[segregation]] during [[cell]] [[division]].<ref name="pmid27427983">{{cite journal |vauthors=van der Crabben SN, Hennus MP, McGregor GA, Ritter DI, Nagamani SC, Wells OS, Harakalova M, Chinn IK, Alt A, Vondrova L, Hochstenbach R, van Montfrans JM, Terheggen-Lagro SW, van Lieshout S, van Roosmalen MJ, Renkens I, Duran K, Nijman IJ, Kloosterman WP, Hennekam E, Orange JS, van Hasselt PM, Wheeler DA, Palecek JJ, Lehmann AR, Oliver AW, Pearl LH, Plon SE, Murray JM, van Haaften G |title=Destabilized SMC5/6 complex leads to chromosome breakage syndrome with severe lung disease |journal=J. Clin. Invest. |volume=126 |issue=8 |pages=2881–92 |date=August 2016 |pmid=27427983 |pmc=4966312 |doi=10.1172/JCI82890 |url=}}</ref>
* NSMCE3 gene encodes a component of the SMC5/SMC6complex.
* The NSMCE3 [[gene]] is located on 15q13.1.
* SMC5/SMC6 complex is important for responses to [[DNA]] damage and [[chromosome]] [[segregation]] during [[cell]] [[division]].<ref name="pmid27427983">{{cite journal |vauthors=van der Crabben SN, Hennus MP, McGregor GA, Ritter DI, Nagamani SC, Wells OS, Harakalova M, Chinn IK, Alt A, Vondrova L, Hochstenbach R, van Montfrans JM, Terheggen-Lagro SW, van Lieshout S, van Roosmalen MJ, Renkens I, Duran K, Nijman IJ, Kloosterman WP, Hennekam E, Orange JS, van Hasselt PM, Wheeler DA, Palecek JJ, Lehmann AR, Oliver AW, Pearl LH, Plon SE, Murray JM, van Haaften G |title=Destabilized SMC5/6 complex leads to chromosome breakage syndrome with severe lung disease |journal=J. Clin. Invest. |volume=126 |issue=8 |pages=2881–92 |date=August 2016 |pmid=27427983 |pmc=4966312 |doi=10.1172/JCI82890 |url=}}</ref>
* LICS syndrome is inherited as an [[autosomal recessive]] pattern.
* Mutation in the NSMCE3 gene leads to LICS syndrome.
* Mutation in the NSMCE3 gene leads to LICS syndrome.
* LICS stands for
* LICS stands for:
**[[Lung disease]]
**[[Lung disease]]
**[[Immunodeficiency]]
**[[Immunodeficiencies]]
**[[Chromosome]] breakage syndrome
**[[Chromosome]] breakage syndrome
* Chromosome breakage syndrome is inherited as an [[autosomal]] [[recessive]] pattern
* Other features include:
* The [[T cells]] and [[B cell]] are defective and patients develop [[acute respiratory distress syndrome]] in early childhood.<ref name="pmid4966312">{{cite journal |vauthors=Rickenbacher J |title=The importance of the regulation for the normal and abnormal development. Experimental investigations on the limb buds of chick embryos |journal=Biol Neonat |volume=12 |issue=1 |pages=65–87 |date=1968 |pmid=4966312 |doi= |url=}}</ref>
** Defective [[T cells]] and [[B cell]]  
** [[Acute respiratory distress syndrome]] in early childhood<ref name="pmid4966312">{{cite journal |vauthors=Rickenbacher J |title=The importance of the regulation for the normal and abnormal development. Experimental investigations on the limb buds of chick embryos |journal=Biol Neonat |volume=12 |issue=1 |pages=65–87 |date=1968 |pmid=4966312 |doi= |url=}}</ref>


==ERCC6L2(Hebo deficiency)==
==ERCC6L2 (Hebo deficiency)==
* ERCC6L2 gene is located on 9q22.32.
* ERCC6L2 gene is located on chromosome 9q22.32.
* ERCC6L2 gene belongs to a family of helicases.
* ERCC6L2 gene belongs to a family of helicases.
* The gene is involved in chromatin unwinding,transcription regulation and DNA recombination and repair.<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>  
* ERCC6L2 gene is involved in chromatin unwinding, transcription regulation, DNA recombination, and repair.<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>  
* Mutation of this ERCC6L2 gene leads to bone marrow failure syndrome 2.<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>
* Mutation of ERCC6L2 gene leads to bone marrow failure syndrome 2 which is inherited as an [[autosomal recessive]] pattern.<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>
* It is inherited as an autosonal recessive pattern.
* Bone marrow failure syndrome 2 is characterized by the followings:
* It is Characterized by  
**Trilineage [[bone marrow failure]]
**Trilineage bone marrow failure
**[[Learning disabilities]]
**Learning disabilities
**[[Microcephaly]]<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>
**Microcephaly<ref name="pmid24507776">{{cite journal |vauthors=Tummala H, Kirwan M, Walne AJ, Hossain U, Jackson N, Pondarre C, Plagnol V, Vulliamy T, Dokal I |title=ERCC6L2 mutations link a distinct bone-marrow-failure syndrome to DNA repair and mitochondrial function |journal=Am. J. Hum. Genet. |volume=94 |issue=2 |pages=246–56 |date=February 2014 |pmid=24507776 |pmc=3928664 |doi=10.1016/j.ajhg.2014.01.007 |url=}}</ref>


==Ligase 1 Deficiency==
==Ligase 1 Deficiency==
 
* LIG1 gene is located on chromosome 19q13.33.
* LIG1 gene is located on 19q13.33
* LIG1 gene encodes DNA ligase.
* DNA ligase is encoded by LIG1 gene.
* DNA ligase function at the replication fork is to join okazaki fragments during replication of lagging strand DNA.<ref name="pmid12124343">{{cite journal |vauthors=Harrison C, Ketchen AM, Redhead NJ, O'Sullivan MJ, Melton DW |title=Replication failure, genome instability, and increased cancer susceptibility in mice with a point mutation in the DNA ligase I gene |journal=Cancer Res. |volume=62 |issue=14 |pages=4065–74 |date=July 2002 |pmid=12124343 |doi= |url=}}</ref>
* LIG1 functions at the replication fork to join Okazaki fragments during replication of lagging strand DNA.<ref name="pmid12124343">{{cite journal |vauthors=Harrison C, Ketchen AM, Redhead NJ, O'Sullivan MJ, Melton DW |title=Replication failure, genome instability, and increased cancer susceptibility in mice with a point mutation in the DNA ligase I gene |journal=Cancer Res. |volume=62 |issue=14 |pages=4065–74 |date=July 2002 |pmid=12124343 |doi= |url=}}</ref>
* Mutation of LIIG1 gene leads to reclassified-variant of unknown significance formerly called as DNA ligase 1 deficiency.
* Mutation of this gene leads reclassified -variant of unknown significance(formerly called as DNA LIGASE I DEFICIENCY).
* Ligase 1 deficiency is characterized by:
* It is characterized by immunodeficiencies and cellular hypersensitivity to DNA-damaging agents.<ref name="pmid1581963">{{cite journal |vauthors=Barnes DE, Tomkinson AE, Lehmann AR, Webster AD, Lindahl T |title=Mutations in the DNA ligase I gene of an individual with immunodeficiencies and cellular hypersensitivity to DNA-damaging agents |journal=Cell |volume=69 |issue=3 |pages=495–503 |date=May 1992 |pmid=1581963 |doi= |url=}}</ref>
** [[Immunodeficiency]]
** [[Cellular]] [[hypersensitivity]] to [[DNA]]-damaging agents<ref name="pmid1581963">{{cite journal |vauthors=Barnes DE, Tomkinson AE, Lehmann AR, Webster AD, Lindahl T |title=Mutations in the DNA ligase I gene of an individual with immunodeficiencies and cellular hypersensitivity to DNA-damaging agents |journal=Cell |volume=69 |issue=3 |pages=495–503 |date=May 1992 |pmid=1581963 |doi= |url=}}</ref>


==GINS1 deficiency==
==GINS1 deficiency==
* GINS1 gene is located on 20p11.2  
* GINS1 gene is located on [[chromosome]] 20p11.2.
* This gene encodes for GINS complex.  
* GINS1 gene encodes GINS complex.  
* It is inherited as an autosomal recessive pattern.
* GINS1 deficiency is inherited as an [[autosomal recessive]] pattern.
* It is characterized by  
* GINS1 deficiency is characterized by followings:
**Natural killer (NK) cell deficiency
**[[Natural killer T cell|Natural killer]] cell deficiency
**Chronic neutropenia
**Chronic neutropenia
**Intrauterine growth retardation
**[[Intrauterine growth retardation]]
**Mild facial dysmorphism
**Mild facial dysmorphism
**Eczematous skin
**[[Eczematous Scaling|Eczematous]] skin
**Recurrent infections<ref name="pmid28414293">{{cite journal |vauthors=Cottineau J, Kottemann MC, Lach FP, Kang YH, Vély F, Deenick EK, Lazarov T, Gineau L, Wang Y, Farina A, Chansel M, Lorenzo L, Piperoglou C, Ma CS, Nitschke P, Belkadi A, Itan Y, Boisson B, Jabot-Hanin F, Picard C, Bustamante J, Eidenschenk C, Boucherit S, Aladjidi N, Lacombe D, Barat P, Qasim W, Hurst JA, Pollard AJ, Uhlig HH, Fieschi C, Michon J, Bermudez VP, Abel L, de Villartay JP, Geissmann F, Tangye SG, Hurwitz J, Vivier E, Casanova JL, Smogorzewska A, Jouanguy E |title=Inherited GINS1 deficiency underlies growth retardation along with neutropenia and NK cell deficiency |journal=J. Clin. Invest. |volume=127 |issue=5 |pages=1991–2006 |date=May 2017 |pmid=28414293 |pmc=5409070 |doi=10.1172/JCI90727 |url=}}</ref>
**Recurrent [[infections]]<ref name="pmid28414293">{{cite journal |vauthors=Cottineau J, Kottemann MC, Lach FP, Kang YH, Vély F, Deenick EK, Lazarov T, Gineau L, Wang Y, Farina A, Chansel M, Lorenzo L, Piperoglou C, Ma CS, Nitschke P, Belkadi A, Itan Y, Boisson B, Jabot-Hanin F, Picard C, Bustamante J, Eidenschenk C, Boucherit S, Aladjidi N, Lacombe D, Barat P, Qasim W, Hurst JA, Pollard AJ, Uhlig HH, Fieschi C, Michon J, Bermudez VP, Abel L, de Villartay JP, Geissmann F, Tangye SG, Hurwitz J, Vivier E, Casanova JL, Smogorzewska A, Jouanguy E |title=Inherited GINS1 deficiency underlies growth retardation along with neutropenia and NK cell deficiency |journal=J. Clin. Invest. |volume=127 |issue=5 |pages=1991–2006 |date=May 2017 |pmid=28414293 |pmc=5409070 |doi=10.1172/JCI90727 |url=}}</ref>


==Cartilage Hair Hypoplasia==
==Cartilage hair hypoplasia==
* It is also known as Metaphyseal chondroplasia.
* Cartilage hair hypoplasia is also known as metaphyseal chondroplasia.
* It is caused by homozygous or compound heterozygous mutation in the RMRP gene.
* Cartilage hair hypoplasia  is caused by mutation in the RMRP gene.
* RMRP gene is located on chromosome 9p13.
* RMRP gene is located on chromosome 9p13.
* RMRP gene endoribonuclease RNase MRP composed of an RNA molecule which is attached to many proteins.<ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref>
* RMRP gene encodes mitochondrial RNA-processing endoribonuclease which is involved in cleavage of RNA in mitochondrial DNA synthesis and nucleolar cleaving of pre-rRNA.<ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref><ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref>
* It is involved in
* Cartilage hair hypoplasia is inherited as an [[autosomal recessive]] pattern.
**Cleavage of RNA in mitochondrial DNA synthesis
* Cartilage hair hypoplasia is characterized by the followings:
**Nucleolar cleaving of pre-rRNA.<ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref>
**Short limbs
* Mutation of the RMRP gene leads to cartilage hair hypoplasia.
**[[Short stature]]
* It is inherited as an autosomal recessive pattern.
**Fine and sparse hair
* It is characterized by
**[[Ligamentous]] laxity
**Short-limbs
**Short stature
**Fine, sparse hair
**Ligamentous laxity
**Defective immunity
**Defective immunity
**Hypoplastic anemia
**[[Hypoplastic]] [[anemia]]
**Neuronal dysplasia of the intestine<ref name="pmid14284412">{{cite journal |vauthors=MCKUSICK VA, ELDRIDGE R, HOSTETLER JA, RUANGWIT U, EGELAND JA |title=DWARFISM IN THE AMISH. II. CARTILAGE-HAIR HYPOPLASIA |journal=Bull Johns Hopkins Hosp |volume=116 |issue= |pages=285–326 |date=May 1965 |pmid=14284412 |doi= |url=}}</ref>
**Neuronal [[dysplasia]] of the intestine<ref name="pmid14284412">{{cite journal |vauthors=MCKUSICK VA, ELDRIDGE R, HOSTETLER JA, RUANGWIT U, EGELAND JA |title=DWARFISM IN THE AMISH. II. CARTILAGE-HAIR HYPOPLASIA |journal=Bull Johns Hopkins Hosp |volume=116 |issue= |pages=285–326 |date=May 1965 |pmid=14284412 |doi= |url=}}</ref><ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref>  
* It also includes ligamentous laxity, defective immunity, hypoplastic anemia, and neuronal dysplasia of the intestine.<ref name="pmid11207361">{{cite journal |vauthors=Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A |title=Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia |journal=Cell |volume=104 |issue=2 |pages=195–203 |date=January 2001 |pmid=11207361 |doi= |url=}}</ref>  
* Clinical diagnosis is made by observing fine and sometimes sparse hair in an individual with short stature and disproportionally short limbs.<ref name="pmid19150606">{{cite journal |vauthors=Rider NL, Morton DH, Puffenberger E, Hendrickson CL, Robinson DL, Strauss KA |title=Immunologic and clinical features of 25 Amish patients with RMRP 70 A-->G cartilage hair hypoplasia |journal=Clin. Immunol. |volume=131 |issue=1 |pages=119–28 |date=April 2009 |pmid=19150606 |doi=10.1016/j.clim.2008.11.001 |url=}}</ref>
* Clinical diagnosis is made by observing fine and sometimes sparse hair in an individual with short stature and disproportionally short limbs.<ref name="pmid19150606">{{cite journal |vauthors=Rider NL, Morton DH, Puffenberger E, Hendrickson CL, Robinson DL, Strauss KA |title=Immunologic and clinical features of 25 Amish patients with RMRP 70 A-->G cartilage hair hypoplasia |journal=Clin. Immunol. |volume=131 |issue=1 |pages=119–28 |date=April 2009 |pmid=19150606 |doi=10.1016/j.clim.2008.11.001 |url=}}</ref>
* Suspected cases of skeletal dysplasia may be evaluated on radiography
* Suspected cases of skeletal dysplasia may be evaluated on radiography.
* X- ray findings shows metaphyseal ends are abnormal and appear as scalloped, irregular surfaces that may contain cystic areas.<ref name="pmid1437368">{{cite journal |vauthors=Mäkitie O, Marttinen E, Kaitila I |title=Skeletal growth in cartilage-hair hypoplasia. A radiological study of 82 patients |journal=Pediatr Radiol |volume=22 |issue=6 |pages=434–9 |date=1992 |pmid=1437368 |doi= |url=}}</ref>
* X-ray findings shows metaphyseal ends to be abnormal and appear as scalloped, irregular surfaces that may contain cystic areas.<ref name="pmid1437368">{{cite journal |vauthors=Mäkitie O, Marttinen E, Kaitila I |title=Skeletal growth in cartilage-hair hypoplasia. A radiological study of 82 patients |journal=Pediatr Radiol |volume=22 |issue=6 |pages=434–9 |date=1992 |pmid=1437368 |doi= |url=}}</ref>
* Definitive diagnosis is made by Genetic analysis of the RMRP gene.
* Definitive diagnosis is made by genetic analysis of the RMRP gene.


==Schimke Syndrome==
==Schimke Immuno-osseous dysplasia (SIOD)==
* Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive disorder.
* SMARCAL1 gene is located on chromosome 2q25.
* SIODis caused by homozygous or compound heterozygous mutation in the SMARCAL1 gene on chromosome 2q25.<ref name="pmid11799392">{{cite journal |vauthors=Boerkoel CF, Takashima H, John J, Yan J, Stankiewicz P, Rosenbarker L, André JL, Bogdanovic R, Burguet A, Cockfield S, Cordeiro I, Fründ S, Illies F, Joseph M, Kaitila I, Lama G, Loirat C, McLeod DR, Milford DV, Petty EM, Rodrigo F, Saraiva JM, Schmidt B, Smith GC, Spranger J, Stein A, Thiele H, Tizard J, Weksberg R, Lupski JR, Stockton DW |title=Mutant chromatin remodeling protein SMARCAL1 causes Schimke immuno-osseous dysplasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=215–20 |date=February 2002 |pmid=11799392 |doi=10.1038/ng821 |url=}}</ref>
* SMARCAL1 gene encodes matrix-associated, actin-dependent regulator of chromatin, subfamily a-like 1.<ref name="pmid11799392">{{cite journal |vauthors=Boerkoel CF, Takashima H, John J, Yan J, Stankiewicz P, Rosenbarker L, André JL, Bogdanovic R, Burguet A, Cockfield S, Cordeiro I, Fründ S, Illies F, Joseph M, Kaitila I, Lama G, Loirat C, McLeod DR, Milford DV, Petty EM, Rodrigo F, Saraiva JM, Schmidt B, Smith GC, Spranger J, Stein A, Thiele H, Tizard J, Weksberg R, Lupski JR, Stockton DW |title=Mutant chromatin remodeling protein SMARCAL1 causes Schimke immuno-osseous dysplasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=215–20 |date=February 2002 |pmid=11799392 |doi=10.1038/ng821 |url=}}</ref><ref name="pmid10653321">{{cite journal |vauthors=Boerkoel CF, O'Neill S, André JL, Benke PJ, Bogdanovíć R, Bulla M, Burguet A, Cockfield S, Cordeiro I, Ehrich JH, Fründ S, Geary DF, Ieshima A, Illies F, Joseph MW, Kaitila I, Lama G, Leheup B, Ludman MD, McLeod DR, Medeira A, Milford DV, Ormälä T, Rener-Primec Z, Santava A, Santos HG, Schmidt B, Smith GC, Spranger J, Zupancic N, Weksberg R |title=Manifestations and treatment of Schimke immuno-osseous dysplasia: 14 new cases and a review of the literature |journal=Eur. J. Pediatr. |volume=159 |issue=1-2 |pages=1–7 |date=2000 |pmid=10653321 |doi= |url=}}</ref>
* Mutations in SMARCAL1 gene which encodes matrix-associated, actin-dependent regulator of chromatin, subfamily a-like 1).<ref name="pmid11799392">{{cite journal |vauthors=Boerkoel CF, Takashima H, John J, Yan J, Stankiewicz P, Rosenbarker L, André JL, Bogdanovic R, Burguet A, Cockfield S, Cordeiro I, Fründ S, Illies F, Joseph M, Kaitila I, Lama G, Loirat C, McLeod DR, Milford DV, Petty EM, Rodrigo F, Saraiva JM, Schmidt B, Smith GC, Spranger J, Stein A, Thiele H, Tizard J, Weksberg R, Lupski JR, Stockton DW |title=Mutant chromatin remodeling protein SMARCAL1 causes Schimke immuno-osseous dysplasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=215–20 |date=February 2002 |pmid=11799392 |doi=10.1038/ng821 |url=}}</ref>.<ref name="pmid10653321">{{cite journal |vauthors=Boerkoel CF, O'Neill S, André JL, Benke PJ, Bogdanovíć R, Bulla M, Burguet A, Cockfield S, Cordeiro I, Ehrich JH, Fründ S, Geary DF, Ieshima A, Illies F, Joseph MW, Kaitila I, Lama G, Leheup B, Ludman MD, McLeod DR, Medeira A, Milford DV, Ormälä T, Rener-Primec Z, Santava A, Santos HG, Schmidt B, Smith GC, Spranger J, Zupancic N, Weksberg R |title=Manifestations and treatment of Schimke immuno-osseous dysplasia: 14 new cases and a review of the literature |journal=Eur. J. Pediatr. |volume=159 |issue=1-2 |pages=1–7 |date=2000 |pmid=10653321 |doi= |url=}}</ref>
* Homozygous or compound heterozygous mutation of SMARCAL1 gene causes Schimke immuno-osseous dysplasia (SIOD).
* Characterized by short stature (often with prenatal growth deficiency), spondyloepiphyseal dysplasia, defective cellular immunity, and progressive renal failure.
* Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive disorder.<ref name="pmid11799392">{{cite journal |vauthors=Boerkoel CF, Takashima H, John J, Yan J, Stankiewicz P, Rosenbarker L, André JL, Bogdanovic R, Burguet A, Cockfield S, Cordeiro I, Fründ S, Illies F, Joseph M, Kaitila I, Lama G, Loirat C, McLeod DR, Milford DV, Petty EM, Rodrigo F, Saraiva JM, Schmidt B, Smith GC, Spranger J, Stein A, Thiele H, Tizard J, Weksberg R, Lupski JR, Stockton DW |title=Mutant chromatin remodeling protein SMARCAL1 causes Schimke immuno-osseous dysplasia |journal=Nat. Genet. |volume=30 |issue=2 |pages=215–20 |date=February 2002 |pmid=11799392 |doi=10.1038/ng821 |url=}}</ref>
* It is characterized by:
**Short stature (often with prenatal growth deficiency)
**Spondyloepiphyseal dysplasia
**Defective cellular immunity
**Progressive renal failure
* The diagnosis should be considered in patients with short stature and immunodeficiency.
* The diagnosis should be considered in patients with short stature and immunodeficiency.
* Renal function should be assessed if the diagnosis is suspected.
* Renal function should be assessed if the diagnosis is suspected.
* Radiographs for the characteristic bony anomalies should be performed.
* Radiographs for the characteristic bony anomalies should be performed.
* Markedly improved marrow function afterbone marrow transplantation.<ref name="pmid11113849">{{cite journal |vauthors=Petty EM, Yanik GA, Hutchinson RJ, Alter BP, Schmalstieg FC, Levine JE, Ginsburg D, Robillard JE, Castle VP |title=Successful bone marrow transplantation in a patient with Schimke immuno-osseous dysplasia |journal=J. Pediatr. |volume=137 |issue=6 |pages=882–6 |date=December 2000 |pmid=11113849 |doi=10.1067/mpd.2000.109147 |url=}}</ref><ref name="pmid11113849">{{cite journal |vauthors=Petty EM, Yanik GA, Hutchinson RJ, Alter BP, Schmalstieg FC, Levine JE, Ginsburg D, Robillard JE, Castle VP |title=Successful bone marrow transplantation in a patient with Schimke immuno-osseous dysplasia |journal=J. Pediatr. |volume=137 |issue=6 |pages=882–6 |date=December 2000 |pmid=11113849 |doi=10.1067/mpd.2000.109147 |url=}}</ref>
* [[Bone marrow]] transplantation markedly improved the marrow function.<ref name="pmid11113849">{{cite journal |vauthors=Petty EM, Yanik GA, Hutchinson RJ, Alter BP, Schmalstieg FC, Levine JE, Ginsburg D, Robillard JE, Castle VP |title=Successful bone marrow transplantation in a patient with Schimke immuno-osseous dysplasia |journal=J. Pediatr. |volume=137 |issue=6 |pages=882–6 |date=December 2000 |pmid=11113849 |doi=10.1067/mpd.2000.109147 |url=}}</ref><ref name="pmid11113849">{{cite journal |vauthors=Petty EM, Yanik GA, Hutchinson RJ, Alter BP, Schmalstieg FC, Levine JE, Ginsburg D, Robillard JE, Castle VP |title=Successful bone marrow transplantation in a patient with Schimke immuno-osseous dysplasia |journal=J. Pediatr. |volume=137 |issue=6 |pages=882–6 |date=December 2000 |pmid=11113849 |doi=10.1067/mpd.2000.109147 |url=}}</ref>


==MYSM1 deficiency ==
==MYSM1 deficiency ==
* MYSM1 gene is located on 1p32.1
* MYSM1 gene is located on chromosome 1p32.1.
* Myb-like, SWIRM, and MPN domain 1 (MYSM1) is involved in regulation of trancription and mediates histone deubiquitination<ref name="pmid4098839">{{cite journal |vauthors=Nikolaev OV, Titov VN |title=[Surgical treatment of diffuse toxic goiter] |language=Russian |journal=Khirurgiia (Mosk) |volume=46 |issue=4 |pages=121–7 |date=April 1970 |pmid=4098839 |doi= |url=}}</ref>
* MYSM1 gene encodes a deubiquitinase which  is involved in regulation of [[trancription]] and mediates [[histone deubiquitination]].<ref name="pmid4098839">{{cite journal |vauthors=Nikolaev OV, Titov VN |title=[Surgical treatment of diffuse toxic goiter] |language=Russian |journal=Khirurgiia (Mosk) |volume=46 |issue=4 |pages=121–7 |date=April 1970 |pmid=4098839 |doi= |url=}}</ref>
* Its deficiency leads to Bone marrow failure syndrome 4.
* MYSM1 deficiency leads to bone marrow failure syndrome 4.
* It is inherited as an autosomal recessive pattern.<ref name="pmid24288411">{{cite journal |vauthors=Alsultan A, Shamseldin HE, Osman ME, Aljabri M, Alkuraya FS |title=MYSM1 is mutated in a family with transient transfusion-dependent anemia, mild thrombocytopenia, and low NK- and B-cell counts |journal=Blood |volume=122 |issue=23 |pages=3844–5 |date=November 2013 |pmid=24288411 |doi=10.1182/blood-2013-09-527127 |url=}}</ref><ref name="pmid28115216">{{cite journal |vauthors=Bahrami E, Witzel M, Racek T, Puchałka J, Hollizeck S, Greif-Kohistani N, Kotlarz D, Horny HP, Feederle R, Schmidt H, Sherkat R, Steinemann D, Göhring G, Schlegelbeger B, Albert MH, Al-Herz W, Klein C |title=Myb-like, SWIRM, and MPN domains 1 (MYSM1) deficiency: Genotoxic stress-associated bone marrow failure and developmental aberrations |journal=J. Allergy Clin. Immunol. |volume=140 |issue=4 |pages=1112–1119 |date=October 2017 |pmid=28115216 |doi=10.1016/j.jaci.2016.10.053 |url=}}</ref>
* MYSM1 deficiency is inherited as an [[Autosomal recessive disorder|autosomal recessive]] pattern.<ref name="pmid24288411">{{cite journal |vauthors=Alsultan A, Shamseldin HE, Osman ME, Aljabri M, Alkuraya FS |title=MYSM1 is mutated in a family with transient transfusion-dependent anemia, mild thrombocytopenia, and low NK- and B-cell counts |journal=Blood |volume=122 |issue=23 |pages=3844–5 |date=November 2013 |pmid=24288411 |doi=10.1182/blood-2013-09-527127 |url=}}</ref><ref name="pmid28115216">{{cite journal |vauthors=Bahrami E, Witzel M, Racek T, Puchałka J, Hollizeck S, Greif-Kohistani N, Kotlarz D, Horny HP, Feederle R, Schmidt H, Sherkat R, Steinemann D, Göhring G, Schlegelbeger B, Albert MH, Al-Herz W, Klein C |title=Myb-like, SWIRM, and MPN domains 1 (MYSM1) deficiency: Genotoxic stress-associated bone marrow failure and developmental aberrations |journal=J. Allergy Clin. Immunol. |volume=140 |issue=4 |pages=1112–1119 |date=October 2017 |pmid=28115216 |doi=10.1016/j.jaci.2016.10.053 |url=}}</ref>
* MYSM1 deficiency is associated with
* MYSM1 deficiency is associated with:
**Developmental aberrations
**Developmental aberrations
**Progressive bone marrow failure with myelodysplastic features
**Progressive bone marrow failure with [[myelodysplastic]] features
**Increased susceptibility to genotoxic stress.
**Increased susceptibility to [[genotoxic]] stress
* Hematopoiteic stem cell transplant is a curative therapy.
* Hematopoietic stem cell transplant is a curative therapy.


==MOPD1 deficiency==
==MOPD1 deficiency==
* MOPD1 stands for microcephalic osteodysplastic primordial dwarfism type 1.
* MOPD1 stands for [[microcephalic osteodysplastic primordial dwarfism type 1]].
* also known as Taybi-Linder syndrome.
* MOPD1 deficiency, also known as [[Taybi-Linder syndrome]], caused by mutations of RNU4ATAC gene.
* MOPD1 deficiency caused by mutations in the RNU4ATAC gene.
* RNU4ATAC gene encodes a small nuclear [[RNA]] (snRNA) component of the U12-dependent spliceosome on chromosome 2q14.
* RNU4ATAC gene encode a small nuclear RNA (snRNA) component of the U12-dependent spliceosome on chromosome 2q14.
* MOPD1 deficiency is inherited as an [[autosomal recessive]] pattern.<ref name="pmid24288411">{{cite journal |vauthors=Alsultan A, Shamseldin HE, Osman ME, Aljabri M, Alkuraya FS |title=MYSM1 is mutated in a family with transient transfusion-dependent anemia, mild thrombocytopenia, and low NK- and B-cell counts |journal=Blood |volume=122 |issue=23 |pages=3844–5 |date=November 2013 |pmid=24288411 |doi=10.1182/blood-2013-09-527127 |url=}}</ref>
* MOPD1 deficiency is inherited in an autosomal recessive manner.<ref name="pmid24288411">{{cite journal |vauthors=Alsultan A, Shamseldin HE, Osman ME, Aljabri M, Alkuraya FS |title=MYSM1 is mutated in a family with transient transfusion-dependent anemia, mild thrombocytopenia, and low NK- and B-cell counts |journal=Blood |volume=122 |issue=23 |pages=3844–5 |date=November 2013 |pmid=24288411 |doi=10.1182/blood-2013-09-527127 |url=}}</ref>
* [[Microcephalic osteodysplastic primordial dwarfism type 1]] (MOPD1) is characterized by:<ref name="pmid22302400">{{cite journal |vauthors=Pierce MJ, Morse RP |title=The neurologic findings in Taybi-Linder syndrome (MOPD I/III): case report and review of the literature |journal=Am. J. Med. Genet. A |volume=158A |issue=3 |pages=606–10 |date=March 2012 |pmid=22302400 |doi=10.1002/ajmg.a.33958 |url=}}</ref>
 
** [[Intrauterine Growth Retardation|Intrauterine growth retardation]]
* Microcephalic osteodysplastic primordial dwarfism type 1 (MOPD1) is characterized by intrauterine and post-natal growth retardation.<ref name="pmid22302400">{{cite journal |vauthors=Pierce MJ, Morse RP |title=The neurologic findings in Taybi-Linder syndrome (MOPD I/III): case report and review of the literature |journal=Am. J. Med. Genet. A |volume=158A |issue=3 |pages=606–10 |date=March 2012 |pmid=22302400 |doi=10.1002/ajmg.a.33958 |url=}}</ref>
**Post-natal [[growth retardation]] with the following features:
* The infant presents with following features:
***Abnormally small [[head size]]
**Abnormally small head size (microcephaly)
***Abnormal bone growth (skeletal [[dysplasia]])
**Abnormal bone growth (skeletal dysplasia)
**Distinctive [[facial features]]
**Distinctive facial features
**Brain anomalies<ref name="pmid28115216">{{cite journal |vauthors=Bahrami E, Witzel M, Racek T, Puchałka J, Hollizeck S, Greif-Kohistani N, Kotlarz D, Horny HP, Feederle R, Schmidt H, Sherkat R, Steinemann D, Göhring G, Schlegelbeger B, Albert MH, Al-Herz W, Klein C |title=Myb-like, SWIRM, and MPN domains 1 (MYSM1) deficiency: Genotoxic stress-associated bone marrow failure and developmental aberrations |journal=J. Allergy Clin. Immunol. |volume=140 |issue=4 |pages=1112–1119 |date=October 2017 |pmid=28115216 |doi=10.1016/j.jaci.2016.10.053 |url=}}</ref>
**Brain anomalies.<ref name="pmid28115216">{{cite journal |vauthors=Bahrami E, Witzel M, Racek T, Puchałka J, Hollizeck S, Greif-Kohistani N, Kotlarz D, Horny HP, Feederle R, Schmidt H, Sherkat R, Steinemann D, Göhring G, Schlegelbeger B, Albert MH, Al-Herz W, Klein C |title=Myb-like, SWIRM, and MPN domains 1 (MYSM1) deficiency: Genotoxic stress-associated bone marrow failure and developmental aberrations |journal=J. Allergy Clin. Immunol. |volume=140 |issue=4 |pages=1112–1119 |date=October 2017 |pmid=28115216 |doi=10.1016/j.jaci.2016.10.053 |url=}}</ref>
* Diagnosis is made on the basis of the clinical and radiological phenotype.
* Diagnosis is made on the basis of the clinical and radiological phenotype.
* Common radiological features includes:
* Common radiological features include:
**Short tubular bones
**Short tubular [[bones]]
**Enlarged metaphyses
**Enlarged [[metaphyses]]
**Vertebral and pelvic anomalies
**[[Vertebrae|Vertebral]] and [[pelvic]] anomalies
**Elongated clavicles
**Elongated [[clavicles]]
**Bowing of the long bones
**Bowing the long [[bones]]
* There are no specific treatments for MOPD1.
* There are no specific treatments for MOPD1 deficiency. There is only supportive therapy.  
* Treatment is supportive only.  
* The prognosis is poor, as most affected individuals die within the first year of life.
* The prognosis is poor as most affected individuals dying within the first year of life.


==EXTL3 deficiency==
==EXTL3 deficiency==
* EXTL3 stands for exostosin-like-glycosyltransferase 3.
* EXTL3 stands for exostosin-like-glycosyltransferase 3.
* EXTL3 regulates the synthesis of heparan sulfate important for both skeletal development and hematopoiesis.
* EXTL3 gene located on [[chromosome]] 8p21.1
* EXTL3 gene located on chromosome 8p21.1
* EXTL3 regulates the synthesis of [[heparan sulfate]] which is important for both [[skeletal]] development and [[hematopoiesis]].
* Mutation of EXTL3 gene leads to a syndrome called immunoskeletal dysplasia with neurodevelopmental abnormalities.
* Mutation of EXTL3 gene leads to a syndrome called immunoskeletal [[dysplasia]] with [[neurodevelopmental abnormalities]].<ref name="pmid28148688">{{cite journal |vauthors=Volpi S, Yamazaki Y, Brauer PM, van Rooijen E, Hayashida A, Slavotinek A, Sun Kuehn H, Di Rocco M, Rivolta C, Bortolomai I, Du L, Felgentreff K, Ott de Bruin L, Hayashida K, Freedman G, Marcovecchio GE, Capuder K, Rath P, Luche N, Hagedorn EJ, Buoncompagni A, Royer-Bertrand B, Giliani S, Poliani PL, Imberti L, Dobbs K, Poulain FE, Martini A, Manis J, Linhardt RJ, Bosticardo M, Rosenzweig SD, Lee H, Puck JM, Zúñiga-Pflücker JC, Zon L, Park PW, Superti-Furga A, Notarangelo LD |title=EXTL3 mutations cause skeletal dysplasia, immune deficiency, and developmental delay |journal=J. Exp. Med. |volume=214 |issue=3 |pages=623–637 |date=March 2017 |pmid=28148688 |pmc=5339678 |doi=10.1084/jem.20161525 |url=}}</ref>
* EXTL3 deficiency presents with different skeletal abnormalities and neurodevelopmental defects.<ref name="pmid28148688">{{cite journal |vauthors=Volpi S, Yamazaki Y, Brauer PM, van Rooijen E, Hayashida A, Slavotinek A, Sun Kuehn H, Di Rocco M, Rivolta C, Bortolomai I, Du L, Felgentreff K, Ott de Bruin L, Hayashida K, Freedman G, Marcovecchio GE, Capuder K, Rath P, Luche N, Hagedorn EJ, Buoncompagni A, Royer-Bertrand B, Giliani S, Poliani PL, Imberti L, Dobbs K, Poulain FE, Martini A, Manis J, Linhardt RJ, Bosticardo M, Rosenzweig SD, Lee H, Puck JM, Zúñiga-Pflücker JC, Zon L, Park PW, Superti-Furga A, Notarangelo LD |title=EXTL3 mutations cause skeletal dysplasia, immune deficiency, and developmental delay |journal=J. Exp. Med. |volume=214 |issue=3 |pages=623–637 |date=March 2017 |pmid=28148688 |pmc=5339678 |doi=10.1084/jem.20161525 |url=}}</ref>


==Digeorge Syndrome==
==Digeorge Syndrome==
* Digeorge syndrome is caused by a hemizygous deletion of chromosome 22q11.2
* [[22q11.2 deletion syndrome|DiGeorge syndrome]] is caused by a hemizygous [[deletion]] of chromosome 22q11.2 which encodes TBX1 gene.
* The TBX1 gene maps within the Digeorge syndrome region on chromosome 22q11.2
* T-box genes are [[transcription]] factors involved in the regulation of developmental processes.
* T-box genes are transcription factors involved in the regulation of developmental processes.
* Chromosome 22q11.2 deletion syndrome includes [[22q11.2 deletion syndrome|DiGeorge syndrome]] and other similar syndromes such as [[velocardiofacial syndrome]].
* [[22q11.2 deletion syndrome|DiGeorge syndrome]] is inherited as an [[autosomal dominant]] pattern.
* 22q11.2 deletion leads to defective development of the 3rd and 4th pharyngeal pouch system.
* 22q11.2 deletion leads to defective development of the 3rd and 4th pharyngeal pouch system.
* Digeorge syndrome is inherited as an autosomal dominant pattern.
* [[22q11.2 deletion syndrome|DiGeorge syndrome]] presents with the following:<ref name="pmid21200182">{{cite journal |vauthors=McDonald-McGinn DM, Sullivan KE |title=Chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome) |journal=Medicine (Baltimore) |volume=90 |issue=1 |pages=1–18 |date=January 2011 |pmid=21200182 |doi=10.1097/MD.0b013e3182060469 |url=}}</ref>
* Chromosome 22q11.2 deletion syndrome includes DGS and other similar syndromes such as velocardiofacial syndrome.
**[[Conotruncal cardiac anomalies]]
* The classic triad of digeorge syndrome include followigs
**[[Hypoplastic thymus]]
**Conotruncal cardiac anomalies
**[[Hypocalcemia]]
**Hypoplastic thymus
**Palatal abnormalities
**Hypocalcemia
**[[Developmental delay]]
* The phenotype of digeorge syndrome is variable.
** T cell immunodeficiency presents with:
* Palatal abnormalities and developmental delay are common in digeorge syndrome.
***Recurrent sinopulmonary infections  
* Digeorge syndrome presetns with immunodeficiency as T cells are absent.
***[[Severe combined immunodeficiency]]
* Immunodeficiency can range from recurrent sinopulmonary infections (partial DGS) to severe combined immunodeficiency(SCID; complete DGS).
* Any neonate with a [[conotruncal heart lesion]], [[hypocalcemia]] or [[cleft palate]] should be evaluated for [[22q11.2 deletion syndrome|DiGeorge syndrome]].<ref name="pmid24198816">{{cite journal |vauthors=Davies EG |title=Immunodeficiency in DiGeorge Syndrome and Options for Treating Cases with Complete Athymia |journal=Front Immunol |volume=4 |issue= |pages=322 |date=October 2013 |pmid=24198816 |pmc=3814041 |doi=10.3389/fimmu.2013.00322 |url=}}</ref>
* Any neonate with a conotruncal heart lesion, hypocalcemia or cleft palate should be evaluated for digeorge syndrome<ref name="pmid24198816">{{cite journal |vauthors=Davies EG |title=Immunodeficiency in DiGeorge Syndrome and Options for Treating Cases with Complete Athymia |journal=Front Immunol |volume=4 |issue= |pages=322 |date=October 2013 |pmid=24198816 |pmc=3814041 |doi=10.3389/fimmu.2013.00322 |url=}}</ref>
* [[22q11.2 deletion syndrome|DiGeorge syndrome]] is diagnosed by decreased numbers of [[CD3+ T cells]], combined with either characteristic clinical findings or deletion in chromosome 22q11.2.
* Digeorge syndrome is diagnosed by decreased numbers of CD3+ T cells, combined with either characteristic clinical findings or deletion in chromosome 22q11.2
* T cell receptor excision circles (TRECS), a biomarker of T cell development is also used to made by diagnosis during newborn screening.<ref name="pmid4492158">{{cite journal |vauthors=Allison SE |title=A framework for nursing action in a nurse-conducted diabetic management clinic |journal=J Nurs Adm |volume=3 |issue=4 |pages=53–60 |date=1973 |pmid=4492158 |doi= |url=}}</ref>
* T cell receptor excision circles (TRECS), a biomarker of T cell development is also used to made by diagnosis during newborn screening.<ref name="pmid4492158">{{cite journal |vauthors=Allison SE |title=A framework for nursing action in a nurse-conducted diabetic management clinic |journal=J Nurs Adm |volume=3 |issue=4 |pages=53–60 |date=1973 |pmid=4492158 |doi= |url=}}</ref>
* DiGeorge syndrome should be treated with supplementation of vitamin D or calcium and with parathyroid hormone.
* [[22q11.2 deletion syndrome|DiGeorge syndrome]] should be treated with supplementation of [[vitamin D]] or [[calcium]] and with [[parathyroid hormone]].
* Hematopoietic stem cell transplantation is the definitive treatment.
* [[Hematopoietic stem cell transplantation]] is the definitive treatment.<ref name="pmid21570089">{{cite journal |vauthors=Bassett AS, McDonald-McGinn DM, Devriendt K, Digilio MC, Goldenberg P, Habel A, Marino B, Oskarsdottir S, Philip N, Sullivan K, Swillen A, Vorstman J |title=Practical guidelines for managing patients with 22q11.2 deletion syndrome |journal=J. Pediatr. |volume=159 |issue=2 |pages=332–9.e1 |date=August 2011 |pmid=21570089 |pmc=3197829 |doi=10.1016/j.jpeds.2011.02.039 |url=}}</ref>


==TBX1 deficiency==
==TBX1 deficiency==
* TBX1 gene is located on chromosome 22q11.21
* T-box transcription factor, TBX1 gene, also known as T-box protein 1 is located on [[chromosome]] 22q11.21.
* T-box transcription factor TBX1 also known as T-box protein 1.
* Genes in the T-box family play important roles in the formation of [[tissues]] and [[organs]] during [[embryonic]] development.
* Genes in the T-box family play important roles in the formation of tissues and organs during embryonic development.
* [[Mutations]] in the TBX1 gene leads to conotruncal anamoly face syndrome and velocardiofacial syndrome.
* Mutations in the TBX1 gene leads to conotruncal anamoly face syndrome/velocardiofacial syndrome.


==Chromosome 10p13-p14 deletion Syndrome==
==Chromosome 10p13-p14 deletion Syndrome==
* Chromosome 10, monosomy 10p is a rare disease in which the end portion of the short arm (p) of chromosome 10 is missing.
* Chromosome 10p13-p14 deletion syndrome is a rare disease in which the end portion of the short arm (p) of [[chromosome]] 10 is missing.
* The severity of symptoms is variable, depending upon the exact size or location of the deletion on chromosome 10p.
* The severity of symptoms is variable, depending upon the exact size or location of the [[deletion]] on chromosome 10p.
* Clinical features often include followings:
* Clinical features often include followings:
**Severe intellectual disability
**Severe [[mental retardation]]
**Postnatal growth retardation
**[[Postnatal growth retardation]] resulting in [[short stature]]
**Distinctive malformations of the skull and craniofacial region.
**Distinctive malformations of the skull and craniofacial region
**A short neck
**A [[short neck]]
**Congenital heart defects
**[[Congenital heart defects]]
* Monosomy 10p is also frequently associated with growth delays after birth which results in short stature.
* Affected individuals have some features of [[DiGeorge syndrome]].
* Affected individuals have some features of DiGeorge syndrome (DGS).
* Chromosome 10p13-p14 deletion syndrome is diagnosed prenatally by tests such as [[amniocentesis]] or [[chorionic villus sampling]].
* Chromosome 10p13-p14 deletion syndrome is diagnosed prenatally by tests such as amniocentesis or chorionic villus sampling (CVS).
* The treatment of affected individuals is symptomatic and supportive.
* The treatment of affected individuals is symptomatic and supportive.


==CHARGE Syndrome==
==CHARGE Syndrome==
* CHARGE syndrome stands for:
* CHARGE syndrome is caused by [[heterozygous]] [[mutation]] in the CHD7 gene located on chromosome 8q12.
**Coloboma
* CHARGE Syndrome is inherited as an [[autosomal dominant]] pattern.
* CHD7 gene is essential for the formation of [[multipotent]] migratory [[neural crest cells]]. Neural crest cells are [[ectodermal]] in origin, but undergo a major transcriptional reprogramming event and acquire a differentiation potential and ability to migrate throughout the body.
* CHARGE syndrome stands for:<ref name="pmid10590394">{{cite journal |vauthors=Källén K, Robert E, Mastroiacovo P, Castilla EE, Källén B |title=CHARGE Association in newborns: a registry-based study |journal=Teratology |volume=60 |issue=6 |pages=334–43 |date=December 1999 |pmid=10590394 |doi=10.1002/(SICI)1096-9926(199912)60:6<334::AID-TERA5>3.0.CO;2-S |url=}}</ref><ref name="pmid17299439">{{cite journal |vauthors=Sanlaville D, Verloes A |title=CHARGE syndrome: an update |journal=Eur. J. Hum. Genet. |volume=15 |issue=4 |pages=389–99 |date=April 2007 |pmid=17299439 |doi=10.1038/sj.ejhg.5201778 |url=}}</ref>
**[[Coloboma]]
**Heart anamoly
**Heart anamoly
**Choanal atresia
**[[Choanal atresia]]
**Retardation
**[[Retardation]]
**Genital anamolies
**[[Genital anamolies]]
**Ear anamolies
**Ear anamolies
* CHARGE syndrome is caused by [[heterozygous]] [[mutation]] in the CHD7 gene located on chromosome 8q12.
* CHARGE Syndrome is inherited as an autosomal dominant pattern.
* CHD7 gene is essential for the formation of multipotent migratory neural crest.
* Neural crest cell population is ectodermal in origin but undergoes a major transcriptional reprogramming event and acquires a differentiation potential and ability to migrate throughout the body.


== Job Syndrome ==
== Job Syndrome ==
* Job syndrome is also known ashyper-IgE recurrent infection syndrome.
* STAT3 [[gene]] stands for signal transducer and activator of [[transcription]] 3.
* Job syndrome is caused by heterozygous mutation in the STAT3 gene on chromosome 17q21.
* STAT3 [[gene]] is important in the [[JAK-STAT signaling]] pathway activated by [[cytokines]] such as [[IL-6]] and [[IL-2]].
* STAT 3 gene stands for signal transducer and activator of transcription 3.
* Defects in the [[JAK-STAT]] pathway also lead to impaired [[T helper cell type 17]] (Th17) differentiation and function.
* STAT3 gene is important in the JAK-STAT signaling pathway activated by cytokines such as IL-6 and IL-2.
* Defect in [[Th17]] cells function also results in decreased [[neutrophil]] proliferation and [[chemotaxis]] to the site of [[infection]].
* Defects in the JAK-STAT pathway also lead to impaired T helper cell type 17 (Th17) differentiation and function.
* [[Job syndrome]], also known as [[Hyper-IgE syndrome]], is caused by [[heterozygous]] [[mutation]] in the [[STAT3]] [[gene]] on [[chromosome]] 17q21.
* Defect in Th17 cells function also results in decreased neutrophil proliferation and chemotaxis to the site of infection.
* [[Job syndrome]] is inherited as [[autosomal dominant]] pattern.
* Job is inherited as autosomal dominant pattern.
* [[Job syndrome]] is characterized by the following:
* Job syndrome is a combined immunodeficiency disorder characterized by followings:
**Chronic [[eczema]]
**Chronic eczema
**Recurrent [[staphylococcal]] infections resulthing in cold [[abcess]]
**Recurrent Staphylococcal infections resulthing in cold abcess.
**Increased serum [[IgE]]
**Increased serum IgE
**[[Eosinophilia]]
**Eosinophilia
**[[Skeletal]] manifestation such as:
* Job syndrome can also have some skeletal manifestation which includes followings:
***Distinctive [[coarse facial appearance]]
**Distinctive coarse facial appearance
***Abnormal [[dentition]]
**Abnormal dentition
***[[Hyperextensibility]] of the [[joints]]
**Hyperextensibility of the joints
***[[Bone fractures]]
**Bone fractures
* The diagnosis of [[job syndrome]] is based upon the presence of suggestive clinical and laboratory findings, and confirmed by [[molecular testing]] of STAT3 [[gene]].
* The diagnosis of job syndrome is based upon the presence of suggestive clinical and laboratory findings.
* Management of [[jobs syndrome]] is focused on skin care and [[antimicrobial]] prophylaxis.
* Laboratory diagnosis includes
**Elevated total serum IgE levels
**Variable eosinophilia


* The diagnosis can be confirmed by molecular testing of STAT3 gene.
== Comel Netherton syndrome ==
* Management of patients with HIES is focused on skin care and antimicrobil prophylaxis.
* Comel Netherton syndrome is caused by [[mutations]] in the serine protease inhibitor of Kazal type 5 [[gene]] (SPINK5) on [[chromosome]] 5q32.
* SPINK5 [[gene]] encodes a multidomain serine protein kinase known as lymphoepithelial Kazal type inhibitor (LEKTI) expressed in [[epithelial]] and [[mucosal]] surfaces.<ref name="pmid10835624">{{cite journal |vauthors=Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, Bonafé JL, Wilkinson J, Taïeb A, Barrandon Y, Harper JI, de Prost Y, Hovnanian A |title=Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome |journal=Nat. Genet. |volume=25 |issue=2 |pages=141–2 |date=June 2000 |pmid=10835624 |doi=10.1038/75977 |url=}}</ref>
* Lymphoepithelial Kazal type inhibitor directly inhibits [[kallikreins]], especially kallikrein 5 (KLK5).
* Kallikreins are critical [[epidermal]] [[proteases]] and essential for regulating [[skin]] [[desquamation]].
* Comel Netherton syndrome is inherited as an [[autosomal recessive]] pattern.
* Comel Netherton syndrome is clinically characterized by the followings:<ref name="pmid13582191">{{cite journal |vauthors=NETHERTON EW |title=A unique case of trichorrhexis nodosa; bamboo hairs |journal=AMA Arch Derm |volume=78 |issue=4 |pages=483–7 |date=October 1958 |pmid=13582191 |doi= |url=}}</ref>
**[[Congenital]] [[ichthyosiform erythroderma]]
**[[Astrichorrhexis invaginata]] ("bamboo hair")
**[[Atopic]] [[diathesis]]
* [[Comel Netherton syndrome]] patients exhibit absent LEKTI staining in the [[epidermis]].
* [[Genetic testing]] will identify a [[germline]] SPINK5 [[mutation]] and confirm the diagnosis in approximately 66 to 75 percent of cases.<ref name="pmid19487419">{{cite journal |vauthors=Minegishi Y, Saito M, Nagasawa M, Takada H, Hara T, Tsuchiya S, Agematsu K, Yamada M, Kawamura N, Ariga T, Tsuge I, Karasuyama H |title=Molecular explanation for the contradiction between systemic Th17 defect and localized bacterial infection in hyper-IgE syndrome |journal=J. Exp. Med. |volume=206 |issue=6 |pages=1291–301 |date=June 2009 |pmid=19487419 |pmc=2715068 |doi=10.1084/jem.20082767 |url=}}</ref>
* There is no specific therapy for Comel Netherton syndrome. It is mainly supportive.


== Comel Netherton Syndrome ==
==PGM3 deficiency==
* Comel Netherton Syndrome is caused by [[mutations]] in the serine protease inhibitor of Kazal type 5 gene (SPINK5)on chromosome 5q32.
* PGM 3 stands for phosphoglucomutase3.
* Comel Netherton Syndrome is inherited as an [[autosomal recessive]] pattern.
* PGM3 [[gene]] is located on [[chromosome]] 6q14.
* SPINK5 gene encodes a multidomain serine protein kinase known as lymphoepithelial Kazal type inhibitor (LEKTI) expressed in epithelial and mucosal surfaces.<ref name="pmid10835624">{{cite journal |vauthors=Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, Bonafé JL, Wilkinson J, Taïeb A, Barrandon Y, Harper JI, de Prost Y, Hovnanian A |title=Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome |journal=Nat. Genet. |volume=25 |issue=2 |pages=141–2 |date=June 2000 |pmid=10835624 |doi=10.1038/75977 |url=}}</ref>
* [[Mutation]] of PGM3 [[gene]] leads to [[immunodeficiency-23]] (IMD23).<ref name="pmid24589341">{{cite journal |vauthors=Zhang Y, Yu X, Ichikawa M, Lyons JJ, Datta S, Lamborn IT, Jing H, Kim ES, Biancalana M, Wolfe LA, DiMaggio T, Matthews HF, Kranick SM, Stone KD, Holland SM, Reich DS, Hughes JD, Mehmet H, McElwee J, Freeman AF, Freeze HH, Su HC, Milner JD |title=Autosomal recessive phosphoglucomutase 3 (PGM3) mutations link glycosylation defects to atopy, immune deficiency, autoimmunity, and neurocognitive impairment |journal=J. Allergy Clin. Immunol. |volume=133 |issue=5 |pages=1400–9, 1409.e1–5 |date=May 2014 |pmid=24589341 |pmc=4016982 |doi=10.1016/j.jaci.2014.02.013 |url=}}</ref>
* Lymphoepithelial Kazal type inhibitor directly inhibits kallikreins, especially kallikrein 5 (KLK5).
* PGM3 deficiency is inherited as an  [[autosomal recessive]].
* Kallikreins are critical epidermal proteases and essential for regulating skin desquamation.
* PGM3 deficiency, also known as [[immunodeficiency-vasculitis-myoclonus syndrome]], is characterized by the following:<ref name="pmid24698316">{{cite journal |vauthors=Sassi A, Lazaroski S, Wu G, Haslam SM, Fliegauf M, Mellouli F, Patiroglu T, Unal E, Ozdemir MA, Jouhadi Z, Khadir K, Ben-Khemis L, Ben-Ali M, Ben-Mustapha I, Borchani L, Pfeifer D, Jakob T, Khemiri M, Asplund AC, Gustafsson MO, Lundin KE, Falk-Sörqvist E, Moens LN, Gungor HE, Engelhardt KR, Dziadzio M, Stauss H, Fleckenstein B, Meier R, Prayitno K, Maul-Pavicic A, Schaffer S, Rakhmanov M, Henneke P, Kraus H, Eibel H, Kölsch U, Nadifi S, Nilsson M, Bejaoui M, Schäffer AA, Smith CI, Dell A, Barbouche MR, Grimbacher B |title=Hypomorphic homozygous mutations in phosphoglucomutase 3 (PGM3) impair immunity and increase serum IgE levels |journal=J. Allergy Clin. Immunol. |volume=133 |issue=5 |pages=1410–9, 1419.e1–13 |date=May 2014 |pmid=24698316 |pmc=4825677 |doi=10.1016/j.jaci.2014.02.025 |url=}}</ref><ref name="pmid24589341">{{cite journal |vauthors=Zhang Y, Yu X, Ichikawa M, Lyons JJ, Datta S, Lamborn IT, Jing H, Kim ES, Biancalana M, Wolfe LA, DiMaggio T, Matthews HF, Kranick SM, Stone KD, Holland SM, Reich DS, Hughes JD, Mehmet H, McElwee J, Freeman AF, Freeze HH, Su HC, Milner JD |title=Autosomal recessive phosphoglucomutase 3 (PGM3) mutations link glycosylation defects to atopy, immune deficiency, autoimmunity, and neurocognitive impairment |journal=J. Allergy Clin. Immunol. |volume=133 |issue=5 |pages=1400–9, 1409.e1–5 |date=May 2014 |pmid=24589341 |pmc=4016982 |doi=10.1016/j.jaci.2014.02.013 |url=}}</ref>
* Comel Netherton Syndrome is clinically characterized by a triad which include followings:<ref name="pmid13582191">{{cite journal |vauthors=NETHERTON EW |title=A unique case of trichorrhexis nodosa; bamboo hairs |journal=AMA Arch Derm |volume=78 |issue=4 |pages=483–7 |date=October 1958 |pmid=13582191 |doi= |url=}}</ref>
**Recurrent [[respiratory]] and [[skin]] [[infections]] beginning in early childhood
**Congenital ichthyosiform erythroderma
**[[Developmental delay]]
**Astrichorrhexis invaginata ("bamboo hair")
**[[Cognitive impairment]] of varying severity
**Atopic diathesis.
**[[Eczema]]
* Comel Netherton Syndrome patients exhibit absent LEKTI staining in the epidermis.
**Increased serum [[IgE]]
* Genetic testing will identify a germline SPINK5 mutation and confirm the diagnosis in approximately 66 to 75 percent of cases.<ref name="pmid19487419">{{cite journal |vauthors=Minegishi Y, Saito M, Nagasawa M, Takada H, Hara T, Tsuchiya S, Agematsu K, Yamada M, Kawamura N, Ariga T, Tsuge I, Karasuyama H |title=Molecular explanation for the contradiction between systemic Th17 defect and localized bacterial infection in hyper-IgE syndrome |journal=J. Exp. Med. |volume=206 |issue=6 |pages=1291–301 |date=June 2009 |pmid=19487419 |pmc=2715068 |doi=10.1084/jem.20082767 |url=}}</ref>
* There is no specific therapy for NS.
* It is mainly supportive.


==PGM3 deficiency==
* PGM 3 stands for PHOSPHOGLUCOMUTASE 3
* PGM3 gene  is located on chromosome 6q14.
* Mutation of this gene leads to immunodeficiency-23 (IMD23)
* It is also known as IMMUNODEFICIENCY-VASCULITIS-MYOCLONUS SYNDROME.
* IMD23 is inherited as an  [[autosomal recessive]].
* Characterized by recurrent respiratory and skin infections beginning in early childhood.
* Affected individuals also show developmental delay or cognitive impairment of varying severity.
* Laboratory studies includes increased serum IgE.
==Dyskeratosis congenita==
==Dyskeratosis congenita==
* X-linked dyskeratosis congenita (DKCX) is caused by mutation in the DKC1 gene on chromosome Xq28
* Dyskeratosis congenita is caused by [[mutation]] in DKC1 [[gene]] on [[chromosome]] Xq28.<ref name="pmid9888995">{{cite journal |vauthors=Hassock S, Vetrie D, Giannelli F |title=Mapping and characterization of the X-linked dyskeratosis congenita (DKC) gene |journal=Genomics |volume=55 |issue=1 |pages=21–7 |date=January 1999 |pmid=9888995 |doi=10.1006/geno.1998.5600 |url=}}</ref>
* The disorder is caused by defects in the maintenance of telomeres.
* DKC1 [[gene]] maintains [[telomere]] length in rapidly dividing [[cells]].
* Mutations in genes that maintain telomere length in rapidly dividing cells lead to premature cell death, senescence, or genomic instability,
* Mutations in  DKC1 [[gene]] lead to premature [[cell]] death and senescence.<ref name="pmid10591218">{{cite journal |vauthors=Mitchell JR, Wood E, Collins K |title=A telomerase component is defective in the human disease dyskeratosis congenita |journal=Nature |volume=402 |issue=6761 |pages=551–5 |date=December 1999 |pmid=10591218 |doi=10.1038/990141 |url=}}</ref>
* It is characterized as a triad of abnormal skin pigmentation, nail dystrophy, and leukoplakia of the oral mucosa.
* Dyskeratosis congenita is inherited as an X-linked recessive disorder.
* Dyskeratosis congenita is characterized by the following:<ref name="pmid18005359">{{cite journal |vauthors=Kirwan M, Dokal I |title=Dyskeratosis congenita: a genetic disorder of many faces |journal=Clin. Genet. |volume=73 |issue=2 |pages=103–12 |date=February 2008 |pmid=18005359 |doi=10.1111/j.1399-0004.2007.00923.x |url=}}</ref>
**Abnormal [[skin]] [[pigmentation]]
**[[Nail]] [[dystrophy]]
**[[Leukoplakia]] of the [[oral]] [[mucosa]]


==COATS plus syndrome==
==COATS plus syndrome==
* Cerebroretinal microangiopathy with calcifications and cysts-1 (CRMCC1) is also known as COATS plus syndrome.
* COATS plus syndrome is also known as [[cerebroretinal]] [[microangiopathy]] with [[calcifications]] and [[cysts]]-1.
* It is caused by compound heterozygous mutation in the CTC1 gene  on chromosome 17p13.
* COATS plus syndrome is caused by [[mutation]] in the CTC1 [[gene]] on [[chromosome]] 17p13.
* Inherited as an Autoosomal recessive pattern.
* COATS plus syndrome is inherited as an [[autosomal recessive]] pattern.
* Characterized primarily by intracranial calcifications, leukodystrophy, and brain cysts, resulting in spasticity, ataxia, dystonia, seizures, and cognitive decline
* COATS plus syndrome is characterized by followings:<ref name="pmid15002047">{{cite journal |vauthors=Crow YJ, McMenamin J, Haenggeli CA, Hadley DM, Tirupathi S, Treacy EP, Zuberi SM, Browne BH, Tolmie JL, Stephenson JB |title=Coats' plus: a progressive familial syndrome of bilateral Coats' disease, characteristic cerebral calcification, leukoencephalopathy, slow pre- and post-natal linear growth and defects of bone marrow and integument |journal=Neuropediatrics |volume=35 |issue=1 |pages=10–9 |date=February 2004 |pmid=15002047 |doi=10.1055/s-2003-43552 |url=}}</ref>
**[[Retinal]] [[telangiectasias]] with [[exudates]]
**[[Intracranial calcifications]]
**[[Cerebellar]] movement disorder
**[[Osteopenia]]
**[[Leukoencephalopathy]]
**[[Poor growth]]
**[[Bone marrow failure]]


==SAMD9==
==SAMD9 Mutation==
* SMD9 stands for STERILE ALPHA MOTIF DOMAIN-CONTAINING PROTEIN 9   
* SAMD9 [[gene]] stands for sterile alpha motif domain-containing protein 9.  
* It is encoded by the SAMD9 gene located on 7q21.2  
* SAMD9 [[gene]] located on 7q21.2.
* SAMD9 gene is encodes a [[protein]] which is localized in [[cytoplasm]] and involved in regulating [[cell]] proliferation and [[apoptosis]].
* [[Mutation]] of SAMD9 [[gene]] leads to MIRAGE syndrome.
* MIRAGE syndrome is  inherited as an [[autosomal dominant]] pattern.
* MIRAGE syndrome is  inherited as an [[autosomal dominant]] pattern.
* it includes form of syndromic adrenal hypoplasia, characterized by myelodysplasia, infection, restriction of growth, adrenal hypoplasia, genital phenotypes, and enteropathy
* MIRAGE syndrome is form of syndromic [[adrenal]] [[hypoplasia]] characterized by the following:<ref name="pmid27182967">{{cite journal |vauthors=Narumi S, Amano N, Ishii T, Katsumata N, Muroya K, Adachi M, Toyoshima K, Tanaka Y, Fukuzawa R, Miyako K, Kinjo S, Ohga S, Ihara K, Inoue H, Kinjo T, Hara T, Kohno M, Yamada S, Urano H, Kitagawa Y, Tsugawa K, Higa A, Miyawaki M, Okutani T, Kizaki Z, Hamada H, Kihara M, Shiga K, Yamaguchi T, Kenmochi M, Kitajima H, Fukami M, Shimizu A, Kudoh J, Shibata S, Okano H, Miyake N, Matsumoto N, Hasegawa T |title=SAMD9 mutations cause a novel multisystem disorder, MIRAGE syndrome, and are associated with loss of chromosome 7 |journal=Nat. Genet. |volume=48 |issue=7 |pages=792–7 |date=July 2016 |pmid=27182967 |doi=10.1038/ng.3569 |url=}}</ref>
* The condition is often fatal within the first decade of life, usually as a result of invasive infection.
**[[Myelodysplasia]]
* If the Mutation is inherited as an Autosomal Recessive Pattern then it leads to Tumoral calcinosis, familial, normophosphatemic
**[[Infection]]
* Characterized by normophosphatemic familial tumoral calcinosis.
**Restriction of [[growth]]
**[[Adrenal hypoplasia]]
**[[Genital]] phenotypes
**[[Enteropathy]]
* MIRAGE syndrome is often fatal within the first decade of life as a result of invasive [[infection]].
* If the mutation is SAMD9 gene is inherited as an [[autosomal recessive]] pattern, it leads to familial [[tumoral calcinosis]]
* Familial tumoral calcinosis is characterized by massive periarticular and [[visceral]] deposition of [[calcified]] [[tumors]].<ref name="pmid3366131">{{cite journal |vauthors=Metzker A, Eisenstein B, Oren J, Samuel R |title=Tumoral calcinosis revisited--common and uncommon features. Report of ten cases and review |journal=Eur. J. Pediatr. |volume=147 |issue=2 |pages=128–32 |date=February 1988 |pmid=3366131 |doi= |url=}}</ref>


==SAMD9L==
==SAMD9L Mutation==
* SAMD9L stands for STERILE ALPHA MOTIF DOMAIN-CONTAINING PROTEIN 9-LIKE
* SAMD9L stands for sterile alpha motif domain containing [[protein]] 9-like.
* Located on 7q21.
* SAMD9L [[gene]] is located on [[chromosome]] 7q21.2.
* Inherited as an [[Autosomal]] [[Dominant]] pattern.
* [[Mutation]] of SAMD9L [[gene]] leads to ataxia-pancytopenia syndrome.<ref name="pmid27259050">{{cite journal |vauthors=Chen DH, Below JE, Shimamura A, Keel SB, Matsushita M, Wolff J, Sul Y, Bonkowski E, Castella M, Taniguchi T, Nickerson D, Papayannopoulou T, Bird TD, Raskind WH |title=Ataxia-Pancytopenia Syndrome Is Caused by Missense Mutations in SAMD9L |journal=Am. J. Hum. Genet. |volume=98 |issue=6 |pages=1146–1158 |date=June 2016 |pmid=27259050 |pmc=4908176 |doi=10.1016/j.ajhg.2016.04.009 |url=}}</ref>
* Mutation of this [[gene]] leads to [[Ataxia]]-[[pancytopenia]] syndrome.
* [[Ataxia]]-[[pancytopenia]] syndrome is inherited as an [[autosomal dominant]] pattern.<ref name="pmid27259050">{{cite journal |vauthors=Chen DH, Below JE, Shimamura A, Keel SB, Matsushita M, Wolff J, Sul Y, Bonkowski E, Castella M, Taniguchi T, Nickerson D, Papayannopoulou T, Bird TD, Raskind WH |title=Ataxia-Pancytopenia Syndrome Is Caused by Missense Mutations in SAMD9L |journal=Am. J. Hum. Genet. |volume=98 |issue=6 |pages=1146–1158 |date=June 2016 |pmid=27259050 |pmc=4908176 |doi=10.1016/j.ajhg.2016.04.009 |url=}}</ref>
* It characterized by [[cerebellar ataxia]], variable hematologic [[cytopenias]].
* Ataxia-pancytopenia syndrome is characterized by the following:
* It has a presdisposition to [[bone marrow failure]] and [[myeloid]] [[leukemia]].
**[[Cerebellar]] [[ataxia]]
**Variable hematologic [[cytopenias]]
**[[Bone marrow]] failure
**Myeloid leukemia


==Transcobalmin 2 deficiency==
==Transcobalmin 2 deficiency==
* TCN2 gene is located on chromosome 22q12.2
* Transcobalmin 2 deficiency is caused by [[mutation]] in TCN2 [[gene]].
* The TCN2 gene encodes transcobalamin II (TC II), a plasma globulin that acts as the primary transport protein for vitamin B12.  
* TCN2 [[gene]] is located on [[chromosome]] 22q12.2.
* Transcobalamin is also called as VITAMIN B12-BINDING PROTEIN 2.
* The TCN2 [[gene]] encodes transcobalamin II which is a [[plasma]] [[globulin]] that acts as the primary transport [[protein]] for [[vitamin B12]].  
* TC II as well as intrinsic factor (609342) is required for transport of cobalamin from the intestine to the blood.
* Transcobalmin 2 is also called as vitamin B12 binding protein 2.
* Mutation of this gene leads to TCN 2 deficiency which is inherited as an Autosomal Recessive pattern.
* Transcobalamin 2, as well as [[intrinsic factor]], is required for transportation of [[cobalamin]] from the [[intestine]] to the [[blood]].
* It is characterized with onset in early infancy characterized by failure to thrive, megaloblastic anemia, and pancytopenia.
* Transcobalmin 2 deficiency is inherited as an [[autosomal recessive]] pattern.
* Other features include methylmalonic aciduria, recurrent infections, and vomiting and diarrhea.
* Transcobalmin 2 deficiency is characterized by the following:<ref name="pmid19373259">{{cite journal |vauthors=Häberle J, Pauli S, Berning C, Koch HG, Linnebank M |title=TC II deficiency: avoidance of false-negative molecular genetics by RNA-based investigations |journal=J. Hum. Genet. |volume=54 |issue=6 |pages=331–4 |date=June 2009 |pmid=19373259 |doi=10.1038/jhg.2009.34 |url=}}</ref>
* Treatment with cobalamin results in clinical improvement, but the untreated disorder may result in mental retardation and neurologic abnormalities.
**[[Failure to thrive]]
**[[Megaloblastic anemia]]
**[[Pancytopenia]]
**[[Methylmalonic aciduria]]
**[[Recurrent infections]]
**[[Mental retardation]]
**[[Neurologic]] abnormalities
* Definitive treatment is [[cobalamin]] supplement.


==Deficiency causing hereditary folate malabsorption==
==Hereditary Folate Malabsorption==
* Hereditary [[folate]] malabsorption is caused by homozygous or compound heterozygous mutation in the SLC46A1 gene (611672) on chromosome 17q11.
* Hereditary folate malabsorption is caused by [[mutation]] of SLC46A1 [[gene]].
* Hereditary folate malabsorption is an autosomal recessive disorder  
* SLC46A1 [[gene]] is located on [[chromosome]] 17q11.
* Characterized by signs and symptoms of folate deficiency that appear within a few months after birth.  
* Hereditary folate malabsorption is an [[autosomal recessive]] disorder.
* Infants exhibit low blood and cerebrospinal fluid folate levels with megaloblastic anemia, diarrhea, immune deficiency, infections, and neurologic deficits.  
* Hereditary folate malabsorption leads to impaired [[intestinal]] [[folate]] [[absorption]] and impaired [[transport]] of [[folate]] into the [[central nervous system]].
* Treatment with folate supplementation results in resolution of the signs and symptoms.
* Hereditary folate malabsorption presents in infancy and characterized by signs and symptoms of [[folate]] deficiency.
* The disorder is caused by impaired intestinal folate absorption and impaired transport of folate into the central nervous system.
* Hereditary folate malabsorption presents by the following features:<ref name="pmid17129779">{{cite journal |vauthors=Qiu A, Jansen M, Sakaris A, Min SH, Chattopadhyay S, Tsai E, Sandoval C, Zhao R, Akabas MH, Goldman ID |title=Identification of an [[intestinal]] folate transporter and the molecular basis for hereditary folate malabsorption |journal=Cell |volume=127 |issue=5 |pages=917–28 |date=December 2006 |pmid=17129779 |doi=10.1016/j.cell.2006.09.041 |url=}}</ref>
 
**Low [[blood]] and [[cerebrospinal]] fluid [[folate]] levels
==Methylene-tetrahydrofolate-dehydrogenase 1 deficiency==
**[[Megaloblastic anemia]]
**[[Diarrhea]]
**[[Immunodeficiency]]
**[[Infections]]
**[[Neurologic deficits]]
* Definitive treatment is [[folate]] supplementation.


* The MTHFD1 gene encodes a trifunctional protein comprising 5,10-methylenetetrahydrofolate dehydrogenase , 5,10-methenyltetrahydrofolate cyclohydrolase , and 10-formyltetrahydrofolate synthetase.
==MTHFD1 deficiency==
* These 3 sequential reactions are involved in the interconversion of 1-carbon derivatives of tetrahydrofolate (THF) which are substrates for methionine, thymidylate, and de novo purine syntheses.
* The MTHFD1 [[gene]] encodes a trifunctional protein comprising 5,10-methylenetetrahydrofolate dehydrogenase, 5,10-methenyltetrahydrofolate cyclohydrolase and 10-formyltetrahydrofolate synthetase.
* Combined immunodeficiency and megaloblastic anemia with or without hyperhomocysteinemia is an inborn error of folate metabolite.
* These 3 sequential enzymes are involved in the interconversion of 1-carbon derivatives of tetrahydrofolate (THF) which are substrates for [[methionine]], [[thymidylate]], and de novo [[purine]] synthesis.
* It is is an autosomal recessive disorder.
* Mutation of MTHFD1 [[gene]] leads to combined immunodeficiency and [[megaloblastic anemia]] with or without increased [[homocysteinemia]].<ref name="pmid27707659">{{cite journal |vauthors=Ramakrishnan KA, Pengelly RJ, Gao Y, Morgan M, Patel SV, Davies EG, Ennis S, Faust SN, Williams AP |title=Precision Molecular Diagnosis Defines Specific Therapy in Combined Immunodeficiency with Megaloblastic Anemia Secondary to MTHFD1 Deficiency |journal=J Allergy Clin Immunol Pract |volume=4 |issue=6 |pages=1160–1166.e10 |date=2016 |pmid=27707659 |doi=10.1016/j.jaip.2016.07.014 |url=}}</ref>
* Characteized by hemolytic uremic syndrome, macrocytosis, epilepsy, hearing loss, retinopathy, mild mental retardation, lymphopenia involving all subsets, and low T-cell receptor excision circles.
* The MTHFD1 deficiency is inherited as an [[autosomal recessive]] disorder.<ref name="pmid21813566">{{cite journal |vauthors=Watkins D, Schwartzentruber JA, Ganesh J, Orange JS, Kaplan BS, Nunez LD, Majewski J, Rosenblatt DS |title=Novel inborn error of folate metabolism: identification by exome capture and sequencing of [[mutations]] in the MTHFD1 gene in a single proband |journal=J. Med. Genet. |volume=48 |issue=9 |pages=590–2 |date=September 2011 |pmid=21813566 |doi=10.1136/jmedgenet-2011-100286 |url=}}</ref>
* Folinic acid and hydroxycobalamin supplementation is an effective treatment.
* The deficiency is characterized by the following:
**[[Hemolytic uremic syndrome]]
**[[Macrocytosis]]
**[[Epilepsy]]
**[[Hearing loss]]
**[[Retinopathy]]
**Mild [[mental retardation]]
**[[Lymphopenia]]
**Low T-cell receptor excision circle
* MTHFD1 deficiency is treated by [[folinic acid]] and [[hydroxycobalamin]] supplementation.


==NEMO deficiency==
==NEMO deficiency==
* NEMOalso known as IKBKG gene (inhibitor of kappa polypeptide gene enhancer in B cells, kinase gamma/nuclear factor-kappa B essential modulator).
* NEMO stands for NF-kappa-B essential modifier.
* IKBKG belongs to a family of NEMO-like kinases that function in numerous cell signaling pathways.  
* NEMO is encoded by a IKBKG [[gene]] on the X chromosome.
* NEMO-like kinases specifically phosphorylate serine or threonine residues that are followed by a proline residue.
* NEMO also known as IKBKG [[gene]] (inhibitor of kappa polypeptide gene enhancer kinase gamma).<ref name="pmid14523034">{{cite journal |vauthors=Orange JS, Geha RS |title=Finding NEMO: genetic disorders of NF-[kappa]B activation |journal=J. Clin. Invest. |volume=112 |issue=7 |pages=983–5 |date=October 2003 |pmid=14523034 |pmc=200971 |doi=10.1172/JCI19960 |url=}}</ref>
* Ectodermal dysplasia and immune deficiency-1 (EDAID1) is caused by mutation in the IKK-gamma gene (IKBKG or NEMO )on Xq28.
* IKBKG belongs to a family of NEMO-like kinases that function in numerous [[cell]] signaling pathways.  
* It is an X-linked recessive disorder characterized by variable ectodermal features, but most often including hypo/anhidrosis, and various immunologic and infectious phenotypes of differing severity.
* NEMO-like kinases specifically phosphorylate serine or threonine residues that are followed by a [[proline]] residue.
* Mutations in this gene also leads to anhidrotic ectodermal dysplasia with immunodeficiency, osteopetrosis, and lymphedema (OLEDAID).
* [[Ectodermal]] [[dysplasia]] and [[immune deficiency]]-1 (EDAID1) is caused by [[mutation]] in the IKK-gamma gene (IKBKG or NEMO )on Xq28.
* NEMO deficiency is inherited as an [[X-linked recessive]] disorder.
* NEMO deficiency is characterized by [[ectodermal]] [[dysplasia]] with [[combined immunodeficiencies]].<ref name="pmid15356572">{{cite journal |vauthors=Orange JS, Levy O, Brodeur SR, Krzewski K, Roy RM, Niemela JE, Fleisher TA, Bonilla FA, Geha RS |title=Human nuclear factor kappa B essential modulator mutation can result in immunodeficiency without ectodermal dysplasia |journal=J. Allergy Clin. Immunol. |volume=114 |issue=3 |pages=650–6 |date=September 2004 |pmid=15356572 |doi=10.1016/j.jaci.2004.06.052 |url=}}</ref>


==EDA-ID due to IKBA GOF mutation==
==EDA-ID due to IKBA GOF mutation==
* Mutations in the NFKBIA gene result in functional impairment of NFKB ), a master transcription factor required for normal activation of immune responses.
* Mutations in the NFKBIA gene result in functional impairment of NFKB , a master [[transcription]] factor required for normal activation of [[immune]] responses.
* Interruption of NFKB signaling results in decreased production of proinflammatory cytokines and certain interferons, rendering patients susceptible to infection.
* Interruption of NFKB signaling results in decreased production of [[proinflammatory]] [[cytokines]] and certain [[interferons]], rendering patients susceptible to [[infection]].
* Ectodermal dysplasia and immune deficiency-2 (EDAID2) is caused by heterozygous mutation in the NFKBIA gene on chromosome 14q13.
* Ectodermal dysplasia and immune deficiency-2 (EDAID2) is caused by heterozygous [[mutation]] in the NFKBIA [[gene]] on [[chromosome]] 14q13.
* It is inherited as an /autosomal dominant pattern
* It is inherited as an [[autosomal dominant]] pattern
* EDAID2 is characterized by variable features of ectodermal dysplasia (e.g., hypo/anhidrosis, sparse hair, tooth anomalies) and various immunologic and infectious phenotypes of differing severity.
* EDAID2 is characterized by variable features of [[ectodermal dysplasia]] e.g.hypo/anhidrosis, [[sparse hair]], tooth anomalies) and various [[immunologic]] and [[infectious]] phenotypes of differing severity.


==Purine nucleoside phosphorylase deficiency==
==Purine nucleoside phosphorylase deficiency==
* Purine nucleoside phosphorylase deficiency is caused by mutation in the PNP gene.
* [[Purine nucleoside phosphorylase]] deficiency is caused by mutation in the PNP [[gene]].
* It is one of the enzymes involved in the purine salvage pathway
* [[Purine nucleoside phosphorylase]] is one of the enzymes of [[purine]] salvage pathway.
* Defects in this enzyme lead to intracellular accumulation of metabolites, including deoxyguanosine triphosphate (dGTP),particularly toxic to thymocytes and T cells
* Defects in purine nucleoside phosphorylase enzyme lead to intracellular accumulation of metabolites that incldes [[deoxyguanosine triphosphate]] (dGTP).
* It is rare autosomal recessive immunodeficiency disorder
* Deoxyguanosine triphosphate is particularly toxic to [[T cells]].<ref name="pmid311004">{{cite journal |vauthors=Mitchell BS, Mejias E, Daddona PE, Kelley WN |title=Purinogenic immunodeficiency diseases: selective toxicity of deoxyribonucleosides for T cells |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=75 |issue=10 |pages=5011–4 |date=October 1978 |pmid=311004 |pmc=336252 |doi= |url=}}</ref>
* Characterized mainly by decreased T-cell function.
* Purine nucleoside phosphorylase deficiency is [[autosomal recessive]] disorder.
* Patients typically present in infancy to early childhood with frequent bacterial, viral, and opportunistic infections and failure to thrive.  
* Purine nucleoside phosphorylase deficiency is characterized mainly by decreased T-cell function.
* It also presents with progressive neurologic symptoms and autoimmune disease.
* Patients typically present in infancy to early childhood with frequent bacterial, viral, and opportunistic infections.<ref name="pmid1384322">{{cite journal |vauthors=Aust MR, Andrews LG, Barrett MJ, Norby-Slycord CJ, Markert ML |title=Molecular analysis of mutations in a patient with purine nucleoside phosphorylase deficiency |journal=Am. J. Hum. Genet. |volume=51 |issue=4 |pages=763–72 |date=October 1992 |pmid=1384322 |pmc=1682776 |doi= |url=}}</ref>
* Purine nucleoside phosphorylase deficiency also presents with progressive neurologic symptoms which includes ataxia, developmental delay and spasticity
* Low serum uric acid associated with T cell deficiency is highly suggestive of PNP deficiency.
* Low serum uric acid associated with T cell deficiency is highly suggestive of PNP deficiency.
* Diagnosis should be confirmed by measurement of PNP enzyme activity.
* Diagnosis of purine nucleoside phosphorylase deficiency is confirmed by measurement of PNP enzyme activity.
* The only curative procedure for PNP deficiency is a hematopoietic stem cell transplantation.
* The only curative procedure for PNP deficiency is a [[hematopoietic stem cell transplantation]].


==ID with multiple intestinal atresias==
==ID with multiple intestinal atresias==
* Also known as FAMILIAL INTESTINAL POLYATRESIA SYNDROME.
* Also known as familial intestinal polyaterisa syndrome.
* Gastrointestinal defects and immunodeficiency syndrome (GIDID) is caused by mutation in the TTC7A gene on chromosome 2p21.
* Mutation in the TTC7A gene leads to gastrointestinal defects and immunodeficiency syndrome.
* Autosomal recessive inheritance.  
* TTC7A gene is located on chromosome 2p21.
* Gastrointestinal defects and immunodeficiency syndrome (GIDID) is characterized by multiple intestinal atresia, in which atresia occurs at various levels throughout the small and large intestines.
* TT7CA stands for tetratricopeptide repeat domain 7A.
* Surgical outcomes are poor, and the condition is usually fatal within the first month of life.  
* TTC7A protein involves in proper development andfunction of both thymic and GI epithelium.<ref name="pmid25546680">{{cite journal |vauthors=Fernandez I, Patey N, Marchand V, Birlea M, Maranda B, Haddad E, Decaluwe H, Le Deist F |title=Multiple intestinal atresia with combined immune deficiency related to TTC7A defect is a multiorgan pathology: study of a French-Canadian-based cohort |journal=Medicine (Baltimore) |volume=93 |issue=29 |pages=e327 |date=December 2014 |pmid=25546680 |pmc=4602622 |doi=10.1097/MD.0000000000000327 |url=}}</ref>
* Some patients exhibit inflammatory bowel disease (IBD), with or without intestinal atresia, and in some cases, the intestinal features are associated with either mild or severe combined immunodeficiency
* Gastrointestinal defects and immunodeficiency syndrome is inherited as an autosomal recessive inheritance.  
* Gastrointestinal defects and immunodeficiency syndrome is characterized by followings
**Multiple intestinal atresia, in which atresia throughout intestines.<ref name="pmid25174867">{{cite journal |vauthors=Lemoine R, Pachlopnik-Schmid J, Farin HF, Bigorgne A, Debré M, Sepulveda F, Héritier S, Lemale J, Talbotec C, Rieux-Laucat F, Ruemmele F, Morali A, Cathebras P, Nitschke P, Bole-Feysot C, Blanche S, Brousse N, Picard C, Clevers H, Fischer A, de Saint Basile G |title=Immune deficiency-related enteropathy-lymphocytopenia-alopecia syndrome results from tetratricopeptide repeat domain 7A deficiency |journal=J. Allergy Clin. Immunol. |volume=134 |issue=6 |pages=1354–1364.e6 |date=December 2014 |pmid=25174867 |doi=10.1016/j.jaci.2014.07.019 |url=}}</ref>
**Combined immunodeficiency
* Surgical outcomes are poor, and the condition is usually fatal within the first month of life.


==Hepatic veno-occlusive disease with immunodeficiency==
==Hepatic veno-occlusive disease with immunodeficiency==
* Hepatic venoocclusive disease with immunodeficiency (VODI) is caused by homozygous mutation in the SP110 gene on chromosome 2q37.
* Hepatic venoocclusive disease with immunodeficiency is caused by mutation in the SP110 gene.
* It is an autosomal recessive primary immunodeficiency associated with hepatic vascular occlusion and fibrosis.  
* SP110 gene is located on chromosome 2q37.
* The immunodeficiency is characterized by severe hypogammaglobulinemia, combined T and B cell immunodeficiency, absent lymph node germinal centers, and absent tissue plasma cells and  and hepatic veno-occlusive disease.
* SP10 gene encodes a protein called SP110 nuclear body protein which is involved in immuni reguation.
* VODI is associated with an 85% mortality if unrecognized and untreated with intravenous immunoglobulin and Pneumocystis jerovici prophylaxis
* Hepatic venoocclusive disease with immunodeficiency is an autosomal recessive disorder.
* Hepatic venoocclusive disease is associated with hepatic vascular occlusion and fibrosis.  
* The immunodeficiency in hepatic venoocclusive disease is characterized by followings:<ref name="pmid16648851">{{cite journal |vauthors=Roscioli T, Cliffe ST, Bloch DB, Bell CG, Mullan G, Taylor PJ, Sarris M, Wang J, Donald JA, Kirk EP, Ziegler JB, Salzer U, McDonald GB, Wong M, Lindeman R, Buckley MF |title=Mutations in the gene encoding the PML nuclear body protein Sp110 are associated with immunodeficiency and hepatic veno-occlusive disease |journal=Nat. Genet. |volume=38 |issue=6 |pages=620–2 |date=June 2006 |pmid=16648851 |doi=10.1038/ng1780 |url=}}</ref>
**Severe hypogammaglobulinemia
**Combined T and B cell immunodeficiency
**Absent lymph node germinal centers
**Absent plasma cells
* Hepatic veno-occlusive disease should be treat with intravenous immunoglobulin and pneumocystis jerovici prophylaxis.


==Vici Syndrome==
==Vici Syndrome==
* EPG5 is the human homolog of the metazoan-specific autophagy gene epg-5, encoding a key autophagy regulator (ectopic P-granules autophagy protein 5).  
* Vici syndrome is caused by mutation in the EPG5 gene.
* EPG5 is implicated in the formation of autolysosomesrome (VICIS)
* EPG5 gene is located on chromosome 18q.
* It is caused by homozygous or compound heterozygous mutation in the EPG5 gene on chromosome 18q.
* EPG5 encodes a gene called EPG5 which stands for ectopic P-granules autophagy protein 5.
* Autosomal recessive inheritance
* Ectopic P-granules autophagy protein 5 a key regulator in autophagy and forms autolysosomesrome.<ref name="pmid23222957">{{cite journal |vauthors=Cullup T, Kho AL, Dionisi-Vici C, Brandmeier B, Smith F, Urry Z, Simpson MA, Yau S, Bertini E, McClelland V, Al-Owain M, Koelker S, Koerner C, Hoffmann GF, Wijburg FA, ten Hoedt AE, Rogers RC, Manchester D, Miyata R, Hayashi M, Said E, Soler D, Kroisel PM, Windpassinger C, Filloux FM, Al-Kaabi S, Hertecant J, Del Campo M, Buk S, Bodi I, Goebel HH, Sewry CA, Abbs S, Mohammed S, Josifova D, Gautel M, Jungbluth H |title=Recessive mutations in EPG5 cause Vici syndrome, a multisystem disorder with defective autophagy |journal=Nat. Genet. |volume=45 |issue=1 |pages=83–7 |date=January 2013 |pmid=23222957 |pmc=4012842 |doi=10.1038/ng.2497 |url=}}</ref>
* Characterized by congenital multisystem disorder characterized by agenesis of the corpus callosum (ACC), cataracts, pigmentary defects, progressive cardiomyopathy, and variable immunodeficiency.
* Vici syndrome is inherited as an autosomal recessive pattern.<ref name="pmid20583151">{{cite journal |vauthors=Al-Owain M, Al-Hashem A, Al-Muhaizea M, Humaidan H, Al-Hindi H, Al-Homoud I, Al-Mogarri I |title=Vici syndrome associated with unilateral lung hypoplasia and myopathy |journal=Am. J. Med. Genet. A |volume=152A |issue=7 |pages=1849–53 |date=July 2010 |pmid=20583151 |doi=10.1002/ajmg.a.33421 |url=}}</ref>
* Affected individuals also have profound psychomotor retardation and hypotonia due to a myopathy.
* Vici syndrome is characterized by followings:<ref name="pmid21965116">{{cite journal |vauthors=Finocchi A, Angelino G, Cantarutti N, Corbari M, Bevivino E, Cascioli S, Randisi F, Bertini E, Dionisi-Vici C |title=Immunodeficiency in Vici syndrome: a heterogeneous phenotype |journal=Am. J. Med. Genet. A |volume=158A |issue=2 |pages=434–9 |date=February 2012 |pmid=21965116 |doi=10.1002/ajmg.a.34244 |url=}}</ref>
**Agenesis of the corpus callosum
**Cataracts
**Pigmentary defects
**Progressive cardiomyopathy
**Variable immunodeficiency
**Profound psychomotor retardation
**Hypotonia due to a myopathy


==HOIL1 deficiency==
==HOIL1 deficiency==
* also known as HEME-OXIDIZED IRP2 UBIQUITIN LIGASE 1
* HOIL1 stands for heme -oxidized IRP2 ubiquitin ligase 1.
* The alternate title for this gene is RBCK1 ( RANBP-TYPE AND C3HC4-TYPE ZINC FINGER-CONTAINING 1).
* HOIL1 also RBCK1 gene.
* PGBM1 (polyglucosan body myopathy-1) is caused by homozygous or compound heterozygous mutation in the RBCK1 gene (610924) on chromosome 20p13.
* RBCK1 gene encodes 1 of the components of the linear ubiquitin chain assembly complex(LUBAC)
* It is inherited as autosomal recessive disorder.
* RBCK1 gene is located on chromosome 20p13
* Polyglucosan body myopathy-1 is characterized by onset in childhood of progressive proximal muscle weakness, resulting in difficulties in ambulation.  
* Mutation in the RBCK1 leads to polyglucosan body myopathy.
* Most patients also develop progressive dilated cardiomyopathy, which may necessitate cardiac transplant in severe cases.
* Polyglucosan body myopathy is inherited as autosomal recessive disorder.<ref name="pmid23798481">{{cite journal |vauthors=Nilsson J, Schoser B, Laforet P, Kalev O, Lindberg C, Romero NB, Dávila López M, Akman HO, Wahbi K, Iglseder S, Eggers C, Engel AG, Dimauro S, Oldfors A |title=Polyglucosan body myopathy caused by defective ubiquitin ligase RBCK1 |journal=Ann. Neurol. |volume=74 |issue=6 |pages=914–9 |date=December 2013 |pmid=23798481 |doi=10.1002/ana.23963 |url=}}</ref>
* A small subset of patients present with severe immunodeficiency and a hyperinflammatory state in very early childhood.
* Polyglucosan body myopathy-1 is characterized by progressive proximal muscle weakness in early childhood.<ref name="pmid23104095">{{cite journal |vauthors=Boisson B, Laplantine E, Prando C, Giliani S, Israelsson E, Xu Z, Abhyankar A, Israël L, Trevejo-Nunez G, Bogunovic D, Cepika AM, MacDuff D, Chrabieh M, Hubeau M, Bajolle F, Debré M, Mazzolari E, Vairo D, Agou F, Virgin HW, Bossuyt X, Rambaud C, Facchetti F, Bonnet D, Quartier P, Fournet JC, Pascual V, Chaussabel D, Notarangelo LD, Puel A, Israël A, Casanova JL, Picard C |title=Immunodeficiency, autoinflammation and amylopectinosis in humans with inherited HOIL-1 and LUBAC deficiency |journal=Nat. Immunol. |volume=13 |issue=12 |pages=1178–86 |date=December 2012 |pmid=23104095 |pmc=3514453 |doi=10.1038/ni.2457 |url=}}</ref>
* Most patients with polyglucosan body myopathy-1 also develop progressive dilated cardiomyopathy.
* Some patients with polyglucosan body myopathy also presents with severe immunodeficiency.


==HOIP1 deficiency==
==HOIP1 deficiency==
* Alternate title is ZIBRA HOIL1-INTERACTING PROTEIN; HOIP
* HOIP stands for Hoil 1-Interacting Protein.
* Caused by the mutation in RNF31 gene to chromosome 14q11.2.  
* HOIP1 deficiency is caused by the mutation in RNF31 gene.
* A patient with multiorgan autoinflammation, combined immunodeficiency, subclinical amylopectinosis, and systemic lymphangiectasia, is homozygous for a mutation in HOIP, the gene encoding the catalytic component of LUBAC.
* RNF31 gene is located chromosome 14q11.2.
* HOIP deficincy is characterized by followings:<ref name="pmid23104095">{{cite journal |vauthors=Boisson B, Laplantine E, Prando C, Giliani S, Israelsson E, Xu Z, Abhyankar A, Israël L, Trevejo-Nunez G, Bogunovic D, Cepika AM, MacDuff D, Chrabieh M, Hubeau M, Bajolle F, Debré M, Mazzolari E, Vairo D, Agou F, Virgin HW, Bossuyt X, Rambaud C, Facchetti F, Bonnet D, Quartier P, Fournet JC, Pascual V, Chaussabel D, Notarangelo LD, Puel A, Israël A, Casanova JL, Picard C |title=Immunodeficiency, autoinflammation and amylopectinosis in humans with inherited HOIL-1 and LUBAC deficiency |journal=Nat. Immunol. |volume=13 |issue=12 |pages=1178–86 |date=December 2012 |pmid=23104095 |pmc=3514453 |doi=10.1038/ni.2457 |url=}}</ref>
**Multiorgan autoinflammation
**Combined immunodeficiency
**Subclinical amylopectinosis
**Systemic lymphangiectasia


==Calcium Channel Defects (ORAI-1 deficiency)==
==Calcium Channel Defects (ORAI-1 deficiency)==
*It usually inherits as an autosomal recessive disorder.
* ORAI1 is also known as calcium release-activated calcium modulator1 (CRAMC1).
*It is also known as ORAI calcium release-activated calcium modulator 1.
* ORAI1 gene is located on chromosome 12q24.
* Primary immunodeficiency-9 (IMD9) is caused by homozygous or compound heterozygous mutation in the ORAI1 gene. ORAI1 gene encodes a subunit of the plasma membrane calcium channel CRAC which is located on chromosome 12q24.
* ORAI1 (CRAMC1) gene encodes a plasma membrane protein essential for pore-forming subunit of the Ca2+ release-activated calcium channels.
* Mutation in the ORAI1 gene leads to primary immunodeficiency-9.<ref name="pmid20004786">{{cite journal |vauthors=McCarl CA, Picard C, Khalil S, Kawasaki T, Röther J, Papolos A, Kutok J, Hivroz C, Ledeist F, Plogmann K, Ehl S, Notheis G, Albert MH, Belohradsky BH, Kirschner J, Rao A, Fischer A, Feske S |title=ORAI1 deficiency and lack of store-operated Ca2+ entry cause immunodeficiency, myopathy, and ectodermal dysplasia |journal=J. Allergy Clin. Immunol. |volume=124 |issue=6 |pages=1311–1318.e7 |date=December 2009 |pmid=20004786 |pmc=2829767 |doi=10.1016/j.jaci.2009.10.007 |url=}}</ref>
* Primary immunodeficiency-9 in inherited as an autosomal recessive disorder.
*Common manifestations of calcium channel defects include followings:
*Common manifestations of calcium channel defects include followings:
**Recurrent infections due to defective T-cell activation  
**Recurrent infections due to defective T-cell activation  
Line 591: Line 665:
**Muscle weakness  
**Muscle weakness  
**Ectodermal dysplasia including soft dental enamel
**Ectodermal dysplasia including soft dental enamel
* If the mutation in the ORAI1 gene is inherited as an autosomal dominant pattern it leads to tubular aggregate myopathy-2.<ref name="pmid15452313">{{cite journal |vauthors=Shahrizaila N, Lowe J, Wills A |title=Familial myopathy with tubular aggregates associated with abnormal pupils |journal=Neurology |volume=63 |issue=6 |pages=1111–3 |date=September 2004 |pmid=15452313 |doi= |url=}}</ref>
* Tubular aggregate myopathy-2 is characterized by muscle pain, cramping, or weakness that begins in childhood and worsens over time.<ref name="pmid27882542">{{cite journal |vauthors=Garibaldi M, Fattori F, Riva B, Labasse C, Brochier G, Ottaviani P, Sacconi S, Vizzaccaro E, Laschena F, Romero NB, Genazzani A, Bertini E, Antonini G |title=A novel gain-of-function mutation in ORAI1 causes late-onset tubular aggregate myopathy and congenital miosis |journal=Clin. Genet. |volume=91 |issue=5 |pages=780–786 |date=May 2017 |pmid=27882542 |doi=10.1111/cge.12888 |url=}}</ref>
* Tubular aggregate myopathy-2 involves build up of proteins abnormally in both type I and type II muscle fibers and forms clumps of tube-like structures called tubular aggregates


==STIM1 deficiency==
==STIM1 deficiency==
* Primary immunodeficiency-10 (IMD10) is caused by homozygous mutation in the STIM1 gene (605921) on chromosome 11p15
* STM1 stands for stromal interaction molecule 1.
* Immunodeficiency-10 is an autosomal recessive primary immunodeficiency characterized by onset of recurrent infections in childhood due to defective T- and NK-cell function butthe severity is variable.
* STIM1 gene is located on chromosome 11p15.
* Affected individuals may also have hypotonia, hypohidrosis, or dental enamel hypoplasia consistent with amelogenesis imperfecta.
* STIM1 gene encode stromal interaction molecule 1
* Stromal interaction molecule1 senses release of Ca2+ from endoplasmic reticulum and activates CRAC channels in the plasma membrane.
* Mutation in the STIM1 gene leads to primary immunodeficiency-10.<ref name="pmid26560041">{{cite journal |vauthors=Parry DA, Holmes TD, Gamper N, El-Sayed W, Hettiarachchi NT, Ahmed M, Cook GP, Logan CV, Johnson CA, Joss S, Peers C, Prescott K, Savic S, Inglehearn CF, Mighell AJ |title=A homozygous STIM1 mutation impairs store-operated calcium entry and natural killer cell effector function without clinical immunodeficiency |journal=J. Allergy Clin. Immunol. |volume=137 |issue=3 |pages=955–7.e8 |date=March 2016 |pmid=26560041 |pmc=4775071 |doi=10.1016/j.jaci.2015.08.051 |url=}}</ref>
* Immunodeficiency-10 is iherited as an autosomal recessive disorder.<ref name="pmid20876309">{{cite journal |vauthors=Byun M, Abhyankar A, Lelarge V, Plancoulaine S, Palanduz A, Telhan L, Boisson B, Picard C, Dewell S, Zhao C, Jouanguy E, Feske S, Abel L, Casanova JL |title=Whole-exome sequencing-based discovery of STIM1 deficiency in a child with fatal classic Kaposi sarcoma |journal=J. Exp. Med. |volume=207 |issue=11 |pages=2307–12 |date=October 2010 |pmid=20876309 |pmc=2964585 |doi=10.1084/jem.20101597 |url=}}</ref>
* Immunodeficiency-10 is characterized by recurrent infections in childhood due to defective T- and NK-cell function.
* Immunodeficiency-10 also have followigs:
**Hypotonia
**Hypohidrosis
**Dental enamel hypoplasia consistent with amelogenesis imperfecta


==Hennekam-lymphangiectasia-lymphedema syndrome 2==
==Hennekam-lymphangiectasia-lymphedema syndrome 2==
*It usually inherits as an autosomal recessive pattern.<ref name="pmid24913602">{{cite journal |vauthors=Alders M, Al-Gazali L, Cordeiro I, Dallapiccola B, Garavelli L, Tuysuz B, Salehi F, Haagmans MA, Mook OR, Majoie CB, Mannens MM, Hennekam RC |title=Hennekam syndrome can be caused by FAT4 mutations and be allelic to Van Maldergem syndrome |journal=Hum. Genet. |volume=133 |issue=9 |pages=1161–7 |date=September 2014 |pmid=24913602 |doi=10.1007/s00439-014-1456-y |url=}}</ref>
* Hennekam lymphangiectasia-lymphedema syndrome-2 is caused by mutation in the FAT4 gene on chromosome 4q28.
*[[Homozygous]] or compound heterozygous mutation in the FAT4 gene on chromosome 4q28 lead to Hennekam lymphangiectasia-lymphedema syndrome-2(HKLLS2).
* Hennekam lymphangiectasia-lymphedema syndrome-2 is inherited as an autosomal recessive pattern.<ref name="pmid24913602">{{cite journal |vauthors=Alders M, Al-Gazali L, Cordeiro I, Dallapiccola B, Garavelli L, Tuysuz B, Salehi F, Haagmans MA, Mook OR, Majoie CB, Mannens MM, Hennekam RC |title=Hennekam syndrome can be caused by FAT4 mutations and be allelic to Van Maldergem syndrome |journal=Hum. Genet. |volume=133 |issue=9 |pages=1161–7 |date=September 2014 |pmid=24913602 |doi=10.1007/s00439-014-1456-y |url=}}</ref>
* FAT4 gene encodes a protein which is a member of a large family of protocadherins.
* FAT4 gene encodes a protein which is a member of a large family of protocadherins.
*It is characterized by generalized lymphatic dysplasia that affects different organs such as the intestinal tract, pericardium, and limbs. It also causes facial dysmorphism and cognitive impairment.<ref name="pmid24913602">{{cite journal |vauthors=Alders M, Al-Gazali L, Cordeiro I, Dallapiccola B, Garavelli L, Tuysuz B, Salehi F, Haagmans MA, Mook OR, Majoie CB, Mannens MM, Hennekam RC |title=Hennekam syndrome can be caused by FAT4 mutations and be allelic to Van Maldergem syndrome |journal=Hum. Genet. |volume=133 |issue=9 |pages=1161–7 |date=September 2014 |pmid=24913602 |doi=10.1007/s00439-014-1456-y |url=}}</ref>
* Hennekam-lymphangiectasia-lymphedema syndrome 2 is characterized by followigs:
**Generalized lymphatic dysplasia
**Facial dysmorphism
**Cognitive impairment.<ref name="pmid24913602">{{cite journal |vauthors=Alders M, Al-Gazali L, Cordeiro I, Dallapiccola B, Garavelli L, Tuysuz B, Salehi F, Haagmans MA, Mook OR, Majoie CB, Mannens MM, Hennekam RC |title=Hennekam syndrome can be caused by FAT4 mutations and be allelic to Van Maldergem syndrome |journal=Hum. Genet. |volume=133 |issue=9 |pages=1161–7 |date=September 2014 |pmid=24913602 |doi=10.1007/s00439-014-1456-y |url=}}</ref>


==STAT5b deficiency==
==STAT5b deficiency==
*STAT5b deficiency also known as signal transducer and activator of transcription 5B.
*STAT5b deficiency also known as signal transducer and activator of transcription 5B.<ref name="pmid13679528">{{cite journal |vauthors=Kofoed EM, Hwa V, Little B, Woods KA, Buckway CK, Tsubaki J, Pratt KL, Bezrodnik L, Jasper H, Tepper A, Heinrich JJ, Rosenfeld RG |title=Growth hormone insensitivity associated with a STAT5b mutation |journal=N. Engl. J. Med. |volume=349 |issue=12 |pages=1139–47 |date=September 2003 |pmid=13679528 |doi=10.1056/NEJMoa022926 |url=}}</ref>
* STAT5 proteins are components of the common [[growth hormone]] and [[interleukin-2]] families of cytokines signaling pathway.
* STAT5 proteins are components of the common [[growth hormone]] and [[interleukin-2]] families of cytokines signaling pathway.
*In response to [[cytokines]] and [[growth factors]], STAT family members are phosphorylated by the receptor associated [[kinases]], and then form homo-or heterodimers that translocate to the cell nucleus where they act as [[transcription]] activators.<ref name="pmid8887644">{{cite journal |vauthors=Wang D, Stravopodis D, Teglund S, Kitazawa J, Ihle JN |title=Naturally occurring dominant negative variants of Stat5 |journal=Mol. Cell. Biol. |volume=16 |issue=11 |pages=6141–8 |date=November 1996 |pmid=8887644 |pmc=231617 |doi= |url=}}</ref>
* STAT family members are phosphorylated by the receptor associated [[kinases]] in response to [[cytokines]] and [[growth factors]].
* GH insensitivity (GHI) is severe growth failure, associated with elevated serum concentrations of GH, resulting in a clinical phenotype that is essentially identical from that of [[congenital]] GH deficiency.<ref name="pmid15827093">{{cite journal |vauthors=Hwa V, Little B, Adiyaman P, Kofoed EM, Pratt KL, Ocal G, Berberoglu M, Rosenfeld RG |title=Severe growth hormone insensitivity resulting from total absence of signal transducer and activator of transcription 5b |journal=J. Clin. Endocrinol. Metab. |volume=90 |issue=7 |pages=4260–6 |date=July 2005 |pmid=15827093 |doi=10.1210/jc.2005-0515 |url=}}</ref>
* STAT proteins then form homo-or heterodimers that translocate to the cell nucleus where they act as [[transcription]] activators.<ref name="pmid8887644">{{cite journal |vauthors=Wang D, Stravopodis D, Teglund S, Kitazawa J, Ihle JN |title=Naturally occurring dominant negative variants of Stat5 |journal=Mol. Cell. Biol. |volume=16 |issue=11 |pages=6141–8 |date=November 1996 |pmid=8887644 |pmc=231617 |doi= |url=}}</ref>
* GHI caused by a [[homozygous]][[Mutations|mutation]] in the gene encoding signal transducer and activator transcription 5B (STAT5B), that is required for normal signaling of the GH receptor .
* Growth hormone insensitivity is caused by a mutation in the STAT5B gene which is required for normal signaling of the GH receptor.<ref name="pmid17389811">{{cite journal |vauthors=Hwa V, Camacho-Hübner C, Little BM, David A, Metherell LA, El-Khatib N, Savage MO, Rosenfeld RG |title=Growth hormone insensitivity and severe short stature in siblings: a novel mutation at the exon 13-intron 13 junction of the STAT5b gene |journal=Horm. Res. |volume=68 |issue=5 |pages=218–24 |date=2007 |pmid=17389811 |doi=10.1159/000101334 |url=}}</ref>
*They have severe postnatal [[growth failure]] and immune dysregulation, because STAT5B mediates signal transduction triggered by various immune ligands, such as [[interleukin-2]] (IL2), [[interleukin-4]] (IL4), and colony-stimulating factor 1 (CSF1).
* Growth hormone insensitivity includes the followings:
**Severe growth failure
**Elevated serum concentrations of GH
**Clinical phenotype that identical to [[congenital]] GH deficiency.<ref name="pmid15827093">{{cite journal |vauthors=Hwa V, Little B, Adiyaman P, Kofoed EM, Pratt KL, Ocal G, Berberoglu M, Rosenfeld RG |title=Severe growth hormone insensitivity resulting from total absence of signal transducer and activator of transcription 5b |journal=J. Clin. Endocrinol. Metab. |volume=90 |issue=7 |pages=4260–6 |date=July 2005 |pmid=15827093 |doi=10.1210/jc.2005-0515 |url=}}</ref>


==Kabuki Syndrome==
==Kabuki Syndrome==
* Kabuki syndrome-1 (KABUK1) is caused by [[heterozygous]] mutation in the MLL2 gene (KMT2D).
* Kabuki syndrome-1 (KABUK1) is caused by [[heterozygous]] mutation in the MLL2 gene (KMT2D).
*[[Histone]] methyltransferase is a protein that encoded by MLL2 gene (KMT2D) which methylates the Lys-4 position of [[histone]] H3.
*MLL2 gene (KMT2D) encodes [[histone]] methyltransferase which methylates the Lys-4 position of [[histone]] H3.
* It usually inherits as an [[autosomal dominant]] pattern.
* It usually inherits as an [[autosomal dominant]] pattern.
*Common manifestations of Kabuki syndrome include:<ref name="pmid7277096">{{cite journal |vauthors=Niikawa N, Matsuura N, Fukushima Y, Ohsawa T, Kajii T |title=Kabuki make-up syndrome: a syndrome of mental retardation, unusual facies, large and protruding ears, and postnatal growth deficiency |journal=J. Pediatr. |volume=99 |issue=4 |pages=565–9 |date=October 1981 |pmid=7277096 |doi= |url=}}</ref><ref name="pmid11223856">{{cite journal |vauthors=Matsune K, Shimizu T, Tohma T, Asada Y, Ohashi H, Maeda T |title=Craniofacial and dental characteristics of Kabuki syndrome |journal=Am. J. Med. Genet. |volume=98 |issue=2 |pages=185–90 |date=January 2001 |pmid=11223856 |doi= |url=}}</ref><ref name="pmid12608719">{{cite journal |vauthors=Petzold D, Kratzsch E, Opitz Ch, Tinschert S |title=The Kabuki syndrome: four patients with oral abnormalities |journal=Eur J Orthod |volume=25 |issue=1 |pages=13–9 |date=February 2003 |pmid=12608719 |doi= |url=}}</ref>
*Common manifestations of Kabuki syndrome include:<ref name="pmid7277096">{{cite journal |vauthors=Niikawa N, Matsuura N, Fukushima Y, Ohsawa T, Kajii T |title=Kabuki make-up syndrome: a syndrome of mental retardation, unusual facies, large and protruding ears, and postnatal growth deficiency |journal=J. Pediatr. |volume=99 |issue=4 |pages=565–9 |date=October 1981 |pmid=7277096 |doi= |url=}}</ref><ref name="pmid11223856">{{cite journal |vauthors=Matsune K, Shimizu T, Tohma T, Asada Y, Ohashi H, Maeda T |title=Craniofacial and dental characteristics of Kabuki syndrome |journal=Am. J. Med. Genet. |volume=98 |issue=2 |pages=185–90 |date=January 2001 |pmid=11223856 |doi= |url=}}</ref><ref name="pmid12608719">{{cite journal |vauthors=Petzold D, Kratzsch E, Opitz Ch, Tinschert S |title=The Kabuki syndrome: four patients with oral abnormalities |journal=Eur J Orthod |volume=25 |issue=1 |pages=13–9 |date=February 2003 |pmid=12608719 |doi= |url=}}</ref>
**Congenital [[mental retardation]] syndrome
**Congenital [[mental retardation]] syndrome
**[[Postnatal]] [[dwarfism]]
**[[Postnatal]] [[dwarfism]]
**long [[palpebral fissures]] with eversion of the lateral third of the lower eyelids (reminiscent of the make-up of actors of Kabuki, a Japanese traditional theatrical form)
**long palpebral fissures with eversion of the lateral third of the lower eyelids (reminiscent of the make-up of actors of Kabuki, a Japanese traditional theatrical form)
**Broad and depressed nasal tip
**Broad and depressed nasal tip
**Large prominent earlobes
**Large prominent earlobes
**[[Cleft lip and palate|Cleft]] or [[high-arched palate]]
**[[Cleft lip and palate|Cleft]] or [[high-arched palate]]
**[[Scoliosis (patient information)|Scoliosis]]
**[[Scoliosis]]
**Short fifth finger
**Short fifth finger
**Persistence of fingerpads
**Persistence of fingerpads
**Radiographic abnormalities of the vertebrae, hands, and hip joints
**Radiographic abnormalities of the [[vertebrae]], [[hands]], and [[hip]] joints
**Recurrent [[otitis]] media in infancy
**Recurrent [[otitis media]] in infancy


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 23:01, 28 January 2019


Immunodeficiency Main Page

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Overview

Classification

Immunodeficiency Affecting Cellular and Humoral Immunity

Combined Immunodeficiency

Predominantly Antibody Deficiency

Diseases of Immune Dysregulation

Congenital Defects of Phagocytes

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Auto-inflammatory Disorders

Complement Deficiencies

Phenocopies of Primary Immunodeficiency

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Ali Akram, M.B.B.S.[3]; Anum Gull M.B.B.S.[4]; Farman Khan, MD, MRCP [5]; Sadaf Sharfaei M.D.[6]

Overview

Please see Common variable immunodeficiency. There are a variety of syndromic conditions related to immunodeficiency. Some syndromic conditions are inherited.

Classification

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Combined Immunodeficiency Diseases with associated or syndromic features
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Congenital thromocytopenia
 
 
DNA Repair Defects
 
 
Immuno-osseous dysplasias
 
 
Thymic Defects with additional congenital anomalies
 
 
Hyper-IgE syndromes(HIES)
 
 
Dyskeratosis congenita (DKC)
 
 
Defects of Vitamin B12 and Folate metabolism
 
 
Anhidrotic Ectodermodysplasia with ID
 
 
Others
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Wiskott Aldrich Syndrome
 
 
 
Ataxia telangiectasia
 
 
 
Cartilage Hair Hypoplasia
 
 
 
DiDeorge Syndrome
 
 
 
Job Syndrome
 
 
 
Dyskeratosis congenita
 
 
 
Transcobalmin 2 deficiency
 
 
 
NEMO deficiency
 
 
 
Purine nucleoside phosphorylase deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
XL thrombocytopenia
 
 
 
Nijmegen breakage Syndrome
 
 
 
Schimke Syndrome
 
 
 
TBX1 deficiency
 
 
 
Comel Netherton Syndrome
 
 
 
COATS plus syndrome
 
 
 
Deficiency causing hereditary folate malabsorption
 
 
 
EDA-ID due to IKBA GOF mutation
 
 
 
ID with multiple intestinal atresias
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
WIP deficiency
 
 
 
Bloom syndrome
 
 
 
MYSM1 deficiency
 
 
 
Chromosome 10p13-p14 deletion Syndrome
 
 
 
PGM3 deficiency
 
 
 
SAMD9
 
 
 
Methylene-tetrahydrofolate-dehydrogenase 1 deficiency
 
 
 
 
 
 
 
 
Hepatic veno-occlusive disease with immunodeficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ARPC1B deficiency
 
 
 
PMS2 deficiency
 
 
 
MOPD1 deficiency
 
 
 
CHARGE Syndrome
 
 
 
 
 
 
 
 
SAMD9L
 
 
 
 
 
 
 
 
 
 
 
 
 
Vici Syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Immunodeficiency with centromeric instability and facial anomalies(ICF1, ICF2, ICF3, ICF4)
 
 
 
EXTL3 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
HOIL1 deficiency, HOIP1 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MCM4 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Calcium Channel Defects(ORAI-1 deficiency, STIM1 deficiency)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RNF168 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hennekam-lymphangiectasia-lymphedema syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
POLE1 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STAT5b deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
POLE2 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Kabuki Syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NSMCE3 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ERCC6L2(Hebo deficiency)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ligase 1 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GINS1 deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Wiskott-Aldrich Syndrome

X-linked thrombocytopenia (XLT)

  • X-Liked thrombocytopenia is a less severe variant of wiskot aldrich syndrome.
  • X-Liked thrombocytopenia presents as a benign disease with good long-term survival compared with classic WAS.[5][6][7]
  • There is a relationship between XLT and WAS as both are caused by mutations of the same gene.[8]
  • WAS gene is mutated in X linked thrombocytopenia .[8]
  • X linked thrombocytopenia is inherited as a X- linked-recessive pattern.
  • X linked thrombocytopenia is characterized by:
    • Mild-to-moderate eczema
    • Mild infrequent infections
    • Small-sized platelets
  • Treatment for patients with XLT is still not determined.[5]

WIP Deficiency

  • WIPF1 gene which is located on chromosome 2q31.1
  • Mutation of WIPF1 gene leads to WIP deficiency.

ARPC1B Deficiency

Ataxia-telangietectasia

Nijmegen breakage Syndrome

Bloom Syndrome

  • Bloom syndrome is also called as Bloom-Torre-Machacek syndrome or congenital telangiectatic erythema.
  • Bloom syndrome is caused by the mutation in the BLM gene which is located on chromosome 15q26.
  • BLM gene encodes DNA helicase RecQ protein-like-3 (RECQL3).[28][29]
  • Bloom Syndrome is inherited as an autosomal recessive inherited disorder.
  • Most common manifestations of Bloom syndrome include followings:[30][28]
  • Bloom syndrome is diagnosed by detecting mutations in BLM gene.[31]
  • There is no specific treatment for bloom syndrome.

PMS2 Deficiency

  • PMS2 also known as Post-Meiotic Segregation 2.

Immunodeficiency with Centromeric instability and Facial anomalies(ICF1, ICF2, ICF3, ICF4)

  • ICF2 is caused by mutation in the ZBTB24 gene on chromosome 6q21.[35]
  • ICF3 is caused by mutation in the CDCA7 gene on chromosome 2q31.
  • ICF4 is caused by mutation in the HELLS gene on chromosome 10q23.

MCM4 Deficiency

RNF168 Deficiency

POLE1 deficiency

POLE2 deficiency

NSMCE3 Deficiency

ERCC6L2 (Hebo deficiency)

  • ERCC6L2 gene is located on chromosome 9q22.32.
  • ERCC6L2 gene belongs to a family of helicases.
  • ERCC6L2 gene is involved in chromatin unwinding, transcription regulation, DNA recombination, and repair.[56]
  • Mutation of ERCC6L2 gene leads to bone marrow failure syndrome 2 which is inherited as an autosomal recessive pattern.[56]
  • Bone marrow failure syndrome 2 is characterized by the followings:

Ligase 1 Deficiency

  • LIG1 gene is located on chromosome 19q13.33.
  • LIG1 gene encodes DNA ligase.
  • DNA ligase function at the replication fork is to join okazaki fragments during replication of lagging strand DNA.[57]
  • Mutation of LIIG1 gene leads to reclassified-variant of unknown significance formerly called as DNA ligase 1 deficiency.
  • Ligase 1 deficiency is characterized by:

GINS1 deficiency

Cartilage hair hypoplasia

  • Cartilage hair hypoplasia is also known as metaphyseal chondroplasia.
  • Cartilage hair hypoplasia is caused by mutation in the RMRP gene.
  • RMRP gene is located on chromosome 9p13.
  • RMRP gene encodes mitochondrial RNA-processing endoribonuclease which is involved in cleavage of RNA in mitochondrial DNA synthesis and nucleolar cleaving of pre-rRNA.[60][60]
  • Cartilage hair hypoplasia is inherited as an autosomal recessive pattern.
  • Cartilage hair hypoplasia is characterized by the followings:
  • Clinical diagnosis is made by observing fine and sometimes sparse hair in an individual with short stature and disproportionally short limbs.[62]
  • Suspected cases of skeletal dysplasia may be evaluated on radiography.
  • X-ray findings shows metaphyseal ends to be abnormal and appear as scalloped, irregular surfaces that may contain cystic areas.[63]
  • Definitive diagnosis is made by genetic analysis of the RMRP gene.

Schimke Immuno-osseous dysplasia (SIOD)

  • SMARCAL1 gene is located on chromosome 2q25.
  • SMARCAL1 gene encodes matrix-associated, actin-dependent regulator of chromatin, subfamily a-like 1.[64][65]
  • Homozygous or compound heterozygous mutation of SMARCAL1 gene causes Schimke immuno-osseous dysplasia (SIOD).
  • Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive disorder.[64]
  • It is characterized by:
    • Short stature (often with prenatal growth deficiency)
    • Spondyloepiphyseal dysplasia
    • Defective cellular immunity
    • Progressive renal failure
  • The diagnosis should be considered in patients with short stature and immunodeficiency.
  • Renal function should be assessed if the diagnosis is suspected.
  • Radiographs for the characteristic bony anomalies should be performed.
  • Bone marrow transplantation markedly improved the marrow function.[66][66]

MYSM1 deficiency

  • MYSM1 gene is located on chromosome 1p32.1.
  • MYSM1 gene encodes a deubiquitinase which is involved in regulation of trancription and mediates histone deubiquitination.[67]
  • MYSM1 deficiency leads to bone marrow failure syndrome 4.
  • MYSM1 deficiency is inherited as an autosomal recessive pattern.[68][69]
  • MYSM1 deficiency is associated with:
    • Developmental aberrations
    • Progressive bone marrow failure with myelodysplastic features
    • Increased susceptibility to genotoxic stress
  • Hematopoietic stem cell transplant is a curative therapy.

MOPD1 deficiency

EXTL3 deficiency

Digeorge Syndrome

TBX1 deficiency

  • T-box transcription factor, TBX1 gene, also known as T-box protein 1 is located on chromosome 22q11.21.
  • Genes in the T-box family play important roles in the formation of tissues and organs during embryonic development.
  • Mutations in the TBX1 gene leads to conotruncal anamoly face syndrome and velocardiofacial syndrome.

Chromosome 10p13-p14 deletion Syndrome

CHARGE Syndrome

Job Syndrome

Comel Netherton syndrome

PGM3 deficiency

Dyskeratosis congenita

COATS plus syndrome

SAMD9 Mutation

SAMD9L Mutation

Transcobalmin 2 deficiency

Hereditary Folate Malabsorption

MTHFD1 deficiency

NEMO deficiency

  • NEMO stands for NF-kappa-B essential modifier.
  • NEMO is encoded by a IKBKG gene on the X chromosome.
  • NEMO also known as IKBKG gene (inhibitor of kappa polypeptide gene enhancer kinase gamma).[94]
  • IKBKG belongs to a family of NEMO-like kinases that function in numerous cell signaling pathways.
  • NEMO-like kinases specifically phosphorylate serine or threonine residues that are followed by a proline residue.
  • Ectodermal dysplasia and immune deficiency-1 (EDAID1) is caused by mutation in the IKK-gamma gene (IKBKG or NEMO )on Xq28.
  • NEMO deficiency is inherited as an X-linked recessive disorder.
  • NEMO deficiency is characterized by ectodermal dysplasia with combined immunodeficiencies.[95]

EDA-ID due to IKBA GOF mutation

Purine nucleoside phosphorylase deficiency

  • Purine nucleoside phosphorylase deficiency is caused by mutation in the PNP gene.
  • Purine nucleoside phosphorylase is one of the enzymes of purine salvage pathway.
  • Defects in purine nucleoside phosphorylase enzyme lead to intracellular accumulation of metabolites that incldes deoxyguanosine triphosphate (dGTP).
  • Deoxyguanosine triphosphate is particularly toxic to T cells.[96]
  • Purine nucleoside phosphorylase deficiency is autosomal recessive disorder.
  • Purine nucleoside phosphorylase deficiency is characterized mainly by decreased T-cell function.
  • Patients typically present in infancy to early childhood with frequent bacterial, viral, and opportunistic infections.[97]
  • Purine nucleoside phosphorylase deficiency also presents with progressive neurologic symptoms which includes ataxia, developmental delay and spasticity
  • Low serum uric acid associated with T cell deficiency is highly suggestive of PNP deficiency.
  • Diagnosis of purine nucleoside phosphorylase deficiency is confirmed by measurement of PNP enzyme activity.
  • The only curative procedure for PNP deficiency is a hematopoietic stem cell transplantation.

ID with multiple intestinal atresias

  • Also known as familial intestinal polyaterisa syndrome.
  • Mutation in the TTC7A gene leads to gastrointestinal defects and immunodeficiency syndrome.
  • TTC7A gene is located on chromosome 2p21.
  • TT7CA stands for tetratricopeptide repeat domain 7A.
  • TTC7A protein involves in proper development andfunction of both thymic and GI epithelium.[98]
  • Gastrointestinal defects and immunodeficiency syndrome is inherited as an autosomal recessive inheritance.
  • Gastrointestinal defects and immunodeficiency syndrome is characterized by followings
    • Multiple intestinal atresia, in which atresia throughout intestines.[99]
    • Combined immunodeficiency
  • Surgical outcomes are poor, and the condition is usually fatal within the first month of life.

Hepatic veno-occlusive disease with immunodeficiency

  • Hepatic venoocclusive disease with immunodeficiency is caused by mutation in the SP110 gene.
  • SP110 gene is located on chromosome 2q37.
  • SP10 gene encodes a protein called SP110 nuclear body protein which is involved in immuni reguation.
  • Hepatic venoocclusive disease with immunodeficiency is an autosomal recessive disorder.
  • Hepatic venoocclusive disease is associated with hepatic vascular occlusion and fibrosis.
  • The immunodeficiency in hepatic venoocclusive disease is characterized by followings:[100]
    • Severe hypogammaglobulinemia
    • Combined T and B cell immunodeficiency
    • Absent lymph node germinal centers
    • Absent plasma cells
  • Hepatic veno-occlusive disease should be treat with intravenous immunoglobulin and pneumocystis jerovici prophylaxis.

Vici Syndrome

  • Vici syndrome is caused by mutation in the EPG5 gene.
  • EPG5 gene is located on chromosome 18q.
  • EPG5 encodes a gene called EPG5 which stands for ectopic P-granules autophagy protein 5.
  • Ectopic P-granules autophagy protein 5 a key regulator in autophagy and forms autolysosomesrome.[101]
  • Vici syndrome is inherited as an autosomal recessive pattern.[102]
  • Vici syndrome is characterized by followings:[103]
    • Agenesis of the corpus callosum
    • Cataracts
    • Pigmentary defects
    • Progressive cardiomyopathy
    • Variable immunodeficiency
    • Profound psychomotor retardation
    • Hypotonia due to a myopathy

HOIL1 deficiency

  • HOIL1 stands for heme -oxidized IRP2 ubiquitin ligase 1.
  • HOIL1 also RBCK1 gene.
  • RBCK1 gene encodes 1 of the components of the linear ubiquitin chain assembly complex(LUBAC)
  • RBCK1 gene is located on chromosome 20p13
  • Mutation in the RBCK1 leads to polyglucosan body myopathy.
  • Polyglucosan body myopathy is inherited as autosomal recessive disorder.[104]
  • Polyglucosan body myopathy-1 is characterized by progressive proximal muscle weakness in early childhood.[105]
  • Most patients with polyglucosan body myopathy-1 also develop progressive dilated cardiomyopathy.
  • Some patients with polyglucosan body myopathy also presents with severe immunodeficiency.

HOIP1 deficiency

  • HOIP stands for Hoil 1-Interacting Protein.
  • HOIP1 deficiency is caused by the mutation in RNF31 gene.
  • RNF31 gene is located chromosome 14q11.2.
  • HOIP deficincy is characterized by followings:[105]
    • Multiorgan autoinflammation
    • Combined immunodeficiency
    • Subclinical amylopectinosis
    • Systemic lymphangiectasia

Calcium Channel Defects (ORAI-1 deficiency)

  • ORAI1 is also known as calcium release-activated calcium modulator1 (CRAMC1).
  • ORAI1 gene is located on chromosome 12q24.
  • ORAI1 (CRAMC1) gene encodes a plasma membrane protein essential for pore-forming subunit of the Ca2+ release-activated calcium channels.
  • Mutation in the ORAI1 gene leads to primary immunodeficiency-9.[106]
  • Primary immunodeficiency-9 in inherited as an autosomal recessive disorder.
  • Common manifestations of calcium channel defects include followings:
    • Recurrent infections due to defective T-cell activation
    • Congenital myopathy
    • Muscle weakness
    • Ectodermal dysplasia including soft dental enamel
  • If the mutation in the ORAI1 gene is inherited as an autosomal dominant pattern it leads to tubular aggregate myopathy-2.[107]
  • Tubular aggregate myopathy-2 is characterized by muscle pain, cramping, or weakness that begins in childhood and worsens over time.[108]
  • Tubular aggregate myopathy-2 involves build up of proteins abnormally in both type I and type II muscle fibers and forms clumps of tube-like structures called tubular aggregates

STIM1 deficiency

  • STM1 stands for stromal interaction molecule 1.
  • STIM1 gene is located on chromosome 11p15.
  • STIM1 gene encode stromal interaction molecule 1
  • Stromal interaction molecule1 senses release of Ca2+ from endoplasmic reticulum and activates CRAC channels in the plasma membrane.
  • Mutation in the STIM1 gene leads to primary immunodeficiency-10.[109]
  • Immunodeficiency-10 is iherited as an autosomal recessive disorder.[110]
  • Immunodeficiency-10 is characterized by recurrent infections in childhood due to defective T- and NK-cell function.
  • Immunodeficiency-10 also have followigs:
    • Hypotonia
    • Hypohidrosis
    • Dental enamel hypoplasia consistent with amelogenesis imperfecta

Hennekam-lymphangiectasia-lymphedema syndrome 2

  • Hennekam lymphangiectasia-lymphedema syndrome-2 is caused by mutation in the FAT4 gene on chromosome 4q28.
  • Hennekam lymphangiectasia-lymphedema syndrome-2 is inherited as an autosomal recessive pattern.[111]
  • FAT4 gene encodes a protein which is a member of a large family of protocadherins.
  • Hennekam-lymphangiectasia-lymphedema syndrome 2 is characterized by followigs:
    • Generalized lymphatic dysplasia
    • Facial dysmorphism
    • Cognitive impairment.[111]

STAT5b deficiency

  • STAT5b deficiency also known as signal transducer and activator of transcription 5B.[112]
  • STAT5 proteins are components of the common growth hormone and interleukin-2 families of cytokines signaling pathway.
  • STAT family members are phosphorylated by the receptor associated kinases in response to cytokines and growth factors.
  • STAT proteins then form homo-or heterodimers that translocate to the cell nucleus where they act as transcription activators.[113]
  • Growth hormone insensitivity is caused by a mutation in the STAT5B gene which is required for normal signaling of the GH receptor.[114]
  • Growth hormone insensitivity includes the followings:
    • Severe growth failure
    • Elevated serum concentrations of GH
    • Clinical phenotype that identical to congenital GH deficiency.[115]

Kabuki Syndrome

  • Kabuki syndrome-1 (KABUK1) is caused by heterozygous mutation in the MLL2 gene (KMT2D).
  • MLL2 gene (KMT2D) encodes histone methyltransferase which methylates the Lys-4 position of histone H3.
  • It usually inherits as an autosomal dominant pattern.
  • Common manifestations of Kabuki syndrome include:[116][117][118]

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