Familial hemophagocytic lymphohistiocytosis in an adult patient homozygous for A91V in the perforin gene, with tuberculosis infection.
Perforin gene (PRF1) mutations have been reported in 20-30% of patients with familial hemophagocytic lymphohistiocytosis (FHL), an autosomal recessive disorder of infancy and early childhood that impairs or abolishes lymphocyte cytotoxicity. We report the first case of FHL in an adult patient homozygous for A91V in PRF1 with tuberculosis. The monozygotic twin of the patient is healthy. A91V confers genetic susceptibility for the development of FHL, but is not enough to trigger the disease on its own. We discuss the role of the A91V change together with M. tuberculosis infection as synergistic factors in the late onset of FHL.
Mancebo
Esther
E
Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Allende
Luis M
LM
Guzmán
María
M
Paz-Artal
Estela
E
Gil
Juana
J
Urrea-Moreno
Ramón
R
Fernández-Cruz
Eduardo
E
Gayà
Antoni
A
Calvo
Javier
J
Arbós
Aina
A
Durán
M Antonia
MA
Canet
Ramón
R
Balanzat
José
J
Udina
María A
MA
Vercher
F Javier
FJ
D006720:Homozygote; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics*; D008875:Middle Aged; D020125:Mutation, Missense; D054353:Perforin; D052899:Pore Forming Cytotoxic Proteins; D014376:Tuberculosis / Q000150:complications*; D014430:Twins, Monozygotic
D008562:Membrane Glycoproteins; D052899:Pore Forming Cytotoxic Proteins; D054353:Perforin