Long-Term Study of a Female Hyper-IgM Immunodeficiency : Original Paper

Hyper-IgM immunodeficiency (HIM) is an immunological disorder characterized by normal or elevated serum IgM levels, and reduced serum IgG and IgA levels, due to the disruption of immunoglobulin class switching in B cells. X-linked hyper-IgM is caused by the defective expression of the CD40 ligand on activated T cells, which induces immunoglobulin class switching along with some cytokines, such as interleukin 4, by the signal transduction of CD40 in B cells. We report on a Japanese girl who initially showed low serum IgM, IgG and IgA levels like patients with common variable immunodeficiency; however, in the course of time, serum IgG levels became reduced and serum IgM levels increased, resulting in the typical immunoglobulin profile of HIM. Neutropenia, one of the features of X-linked HIM, was not observed. In spite of extremely low serum IgG levels, she did not show any predisposition to severe infection, even without gammaglobulin replacement therapy. No mutation of the CD40 ligand or CD40 was detected. Sequencing of the complementarity-determining region of immunoglobulin heavy-chain genes in peripheral B lymphocytes revealed that they were all in frame, and insertion of the N region was detected. These results indicate that the heavy-chain gene rearrangement in the patient’s B cells is intact. Non-X-linked HIM has heterogeneous pathogenetic mechanisms, and some groups may show the resistance to infection at the healthy donor level. The underlying defects in non-X-linked HIM might be specifically involved in class switching..

Medienart:

E-Artikel

Erscheinungsjahr:

2000

Erschienen:

s.l.: Karger ; 2000

Reproduktion:

Karger Journals Archiv 1998-2010

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

Experimental and clinical immunogenetics - 17(2000), 4, Seite 173-178

Sprache:

Englisch

Beteiligte Personen:

Kaneko, Hideo H. [VerfasserIn]
Fukao, Toshiyuki T. [VerfasserIn]
Inoue, Ryousuke R. [VerfasserIn]
Kasahara, Kimiko K. [Sonstige Person]
Matsui, Eiko E. [Sonstige Person]
Kondo, Naomi N. [Sonstige Person]

Links:

Volltext [Deutschlandweit zugänglich]
Volltext [Deutschlandweit zugänglich]

Themen:

CD40 ligand
Clinical course
Complementarity-determining region 3
Female
Hyper-IgM immunodeficiency

Umfang:

Online-Ressource

6

doi:

10.1159/000019136

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLEJ23722478X