Reversible severe combined immunodeficiency phenotype secondary to a mutation of the proton-coupled folate transporter

Hereditary folate malabsorption is a rare inborn error of metabolism due to mutations in the proton-coupled folate transporter (PCFT). Clinical presentation of PCFT deficiency may mimic severe combined immune deficiency (SCID). We report a 4-month-old female who presented with failure to thrive, nor...

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Veröffentlicht in:Clinical immunology (Orlando, Fla.). - 1999. - 133(2009), 3 vom: 15. Dez., Seite 287-94
1. Verfasser: Borzutzky, Arturo (VerfasserIn)
Weitere Verfasser: Crompton, Brian, Bergmann, Anke K, Giliani, Silvia, Baxi, Sachin, Martin, Madelena, Neufeld, Ellis J, Notarangelo, Luigi D
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2009
Zugriff auf das übergeordnete Werk:Clinical immunology (Orlando, Fla.)
Schlagworte:Case Reports Journal Article Research Support, N.I.H., Extramural Membrane Transport Proteins Proton-Coupled Folate Transporter SLC46A1 protein, human DNA 9007-49-2 Folic Acid 935E97BOY8 mehr... Leucovorin Q573I9DVLP
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245 1 0 |a Reversible severe combined immunodeficiency phenotype secondary to a mutation of the proton-coupled folate transporter 
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520 |a Hereditary folate malabsorption is a rare inborn error of metabolism due to mutations in the proton-coupled folate transporter (PCFT). Clinical presentation of PCFT deficiency may mimic severe combined immune deficiency (SCID). We report a 4-month-old female who presented with failure to thrive, normocytic anemia, Pneumocystis jirovecii pneumonia and systemic cytomegalovirus infection. Immunological evaluation revealed hypogammaglobulinemia, absent antibody responses, and lack of mitogen-induced lymphocyte proliferative responses. However, the absolute number and distribution of lymphocyte subsets, including naïve T cells and recent thymic emigrants, were normal, arguing against primary SCID. Serum and cerebrospinal fluid folate levels were undetectable. A homozygous 1082-1G>A mutation of the PCFT gene was found, resulting in skipping of exon 3. Parenteral folinic acid repletion resulted in normalization of anemia, humoral and cellular immunity, and full clinical recovery. PCFT mutations should be considered in infants with SCID-like phenotype, as the immunodeficiency is reversible with parenteral folinic acid repletion 
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650 7 |a Folic Acid  |2 NLM 
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650 7 |a Q573I9DVLP  |2 NLM 
700 1 |a Crompton, Brian  |e verfasserin  |4 aut 
700 1 |a Bergmann, Anke K  |e verfasserin  |4 aut 
700 1 |a Giliani, Silvia  |e verfasserin  |4 aut 
700 1 |a Baxi, Sachin  |e verfasserin  |4 aut 
700 1 |a Martin, Madelena  |e verfasserin  |4 aut 
700 1 |a Neufeld, Ellis J  |e verfasserin  |4 aut 
700 1 |a Notarangelo, Luigi D  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t Clinical immunology (Orlando, Fla.)  |d 1999  |g 133(2009), 3 vom: 15. Dez., Seite 287-94  |w (DE-627)NLM098196855  |x 1521-7035  |7 nnns 
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856 4 0 |u http://dx.doi.org/10.1016/j.clim.2009.08.006  |3 Volltext 
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