Abstract:
:Hemophagocytic lymphohistiocytosis (HLH) is an often-fatal hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, cytopenia, and in some cases hemophagocytosis. Here, we describe the mutation analysis, clinical presentation, and functional analysis of natural killer (NK) cells in patients with mutations in STXBP2 encoding Munc18-2, recently associated with familial HLH type 5. The disease severity among 11 persons studied here was highly variable and, accordingly, age at diagnosis ranged from 2 months to 17 years. Remarkably, in addition to typical manifestations of familial HLH (FHL), the clinical findings included colitis, bleeding disorders, and hypogammaglobulinemia in approximately one-third of the patients. Laboratory analysis revealed impairment of NK-cell degranulation and cytotoxic capacity. Interleukin-2 stimulation of lymphocytes in vitro rescued the NK cell-associated functional defects. In conclusion, familial HLH type 5 is associated with a spectrum of clinical symptoms, which may be a reflection of impaired expression and function of Munc18-2 also in cells other than cytotoxic lymphocytes. Mutations in STXBP2 should thus also be considered in patients with clinical manifestations other than those typically associated with HLH.
journal_name
Bloodjournal_title
Bloodauthors
Meeths M,Entesarian M,Al-Herz W,Chiang SC,Wood SM,Al-Ateeqi W,Almazan F,Boelens JJ,Hasle H,Ifversen M,Lund B,van den Berg JM,Gustafsson B,Hjelmqvist H,Nordenskjöld M,Bryceson YT,Henter JIdoi
10.1182/blood-2010-05-282541subject
Has Abstractpub_date
2010-10-14 00:00:00pages
2635-43issue
15eissn
0006-4971issn
1528-0020pii
blood-2010-05-282541journal_volume
116pub_type
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