AI Article Synopsis
- Janus kinase 3 deficiency, a type of severe combined immunodeficiency (SCID), can lead to fatal outcomes from severe infections, particularly after live-attenuated vaccinations, exemplified by a case of a 5-month-old girl with two unique genetic mutations and complications from BCG disease.
- The patient experienced recurring fever, cough, and showed signs of severe immune deficiency, with tests revealing abnormal lymphocyte levels and the presence of acid-fast bacilli, indicating infection.
- Despite treatment and initial improvement, the girl suffered severe infections and ultimately died at 13 months, highlighting the importance of early SCID detection through newborn screening before vaccination.
Article Abstract
Background: As a form of severe combined immunodeficiency (SCID), Janus kinase 3 () deficiency can be fatal during severe infections in children, especially after inoculation of live-attenuated vaccines. We report a unique case of deficiency with two compound heterozygous mutations complicated by disseminated Bacille Calmette-Guérin (BCG) disease and pneumonia.
Case Description: A 5-month-old Chinese girl presented with recurring fever and productive cough after BCG vaccination and ineffective antibiotic treatment. Chest CT demonstrated bilateral infiltrations, enlarged mediastinal and axillary lymph nodes, and hypoplasia of the thymus. and were detected from blood samples by sequencing. Acid-fast bacilli were also found from the sputum aspirate and gastric aspirate. Lymphocyte subset analyses indicated T-B+NK- immunodeficiency, and gene sequencing identified two heterozygous missense mutations (one unreported globally) in the Janus homology 7 (JH7) domain of . The patient received rifampicin, isoniazid, ethambutol, and trimethoprim/sulfamethoxazole and was discharged after improvements but against advice.
Outcome: The patient died at 13 months of age due to severe infections and hepatic damage.
Discussion: SCID should be recognized before inoculation of live-attenuated vaccines in children. Newborn screening for SCID is advocated. Further investigations are needed to better understand the pathogenicity of the variants and molecular mechanism of the JH7 domain of .
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712176 | PMC |
| http://dx.doi.org/10.3389/fimmu.2022.1055607 | DOI Listing |
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