A case of Nijmegen syndrome in a child with frequent relapses of a respiratory infection

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Abstract

The article provides clinical dynamic observation of a child with a primary immunodeficiency state, presents the stages of the differential diagnostic search for congenital genetic pathology. Nijmegen syndrome is an autosomal recessive disease caused by a mutation of the NBN gene, characterized by microcephaly, “Bird” facial features, delayed physical development, immunodeficiency, congenital malformations, increased sensitivity to x-ray radiation and a high susceptibility to cancer. This syndrome is relevant for Russian pediatricians due to the high frequency of carriage of the “Slavic” NBN gene mutation among the population of the Russian Federation. The presented clinical observation describes a patient with characteristic phenotypic features, frequent episodes of acute respiratory viral infections (up to 8 times a year) with the addition of a bacterial infection, fever up to febrile numbers. The duration of verification of the immunodeficiency state was 5 years. Despite the complicated course of infectious diseases, the general well-being of the child did not suffer significantly, the level of neuropsychic development corresponded to age. The diagnosis of Nijmegen’s syndrome was made on the basis of characteristic phenotypic features, anamnesis, and laboratory data, instrumental studies and confirmed by the results of molecular genetic analysis.

About the authors

Elena A. Besedina

Rostov State Medical University

Author for correspondence.
Email: prometnoy.d.v@gmail.com

MD, PhD, Associate Professor, Chair of Pediatrics No. 1

Russian Federation, Rostov-on-don

Dmitry V. Prometnoy

St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation

Email: prometnoy.d.v@gmail.com

MD, PhD, Associate Professor, Department of Anesthesiology, Resuscitation and Emergency Pediatrics, Faculty of Postgraduate Education

Russian Federation, Saint Petersburg

Svetlana G. Piskunova

Rostov Regional Children Clinical Hospital

Email: prometnoy.d.v@gmail.com

MD, PhD, Head Doctor

Russian Federation, Rostov-on-Don

Olga S. Selezneva

Rostov Regional Children Clinical Hospital

Email: prometnoy.d.v@gmail.com

Head of the Immunological Laboratory

Russian Federation, Rostov-on-Don

Larisa E. Kharakhashyan

Rostov Regional Children Clinical Hospital

Email: prometnoy.d.v@gmail.com

Head of Infectious Diseases Branch

Russian Federation, Rostov-on-Don

Pavel E. Anchutin

Rostov State Medical University

Email: prometnoy.d.v@gmail.com

Postgraduate Student, Chair of Pediatrics No. 1

Russian Federation, Rostov-on-don

References

  1. Дерипапа Е.В. Прогноз и оптимизация терапии на этапах клинической эволюции синдрома Ниймеген у детей: Автореф. дис. … канд. мед. наук. — М., 2018. [Deripapa EV. Prognoz i optimizatsiya terapii na etapakh klinicheskoy evolyutsii sindroma Niymegen u detey. [dissertation] Moscow; 2018. (In Russ.)]
  2. Лаберко А.Л. Опыт применения TCRαβ+ и CD19+ деплеции при неродственных и гаплоидентичных трансплантациях гемопоэтических стволовых клеток у детей с первичными иммунодефицитными состояниями // Вопросы гематологии/онкологии и иммунопатологии в педиатрии. – 2016. – Т. 15. – № 1. – С. 72–80. [Laberko AL, Maschan MA, Shelikhova LN, et al. TCRαβ+ and CD19+ depletion in unrelated and haploidentical hematopoietic stem cell transplantation in children with primary immunodeficiencies. Pediatric haematology/oncology and immunopathology. 2016;15(1):72-80. (In Russ.)]. doi: 10.20953/1726-1708-2016-1-72-80.
  3. Резник И.Б. Эффект основателя при синдроме Ниймеген // Педиатрия. Журнал им. Г.Н. Сперанского. – 2001. – Т. 1. – № 4. – С. 14–18. [Reznik I.B. Effekt osnovatelya pri sindrome Niymegen. Pediatriya. 2001;1(4):14-18. (In Russ.)]
  4. Тюкавкина С.Ю., Харсеева Г.Г., Лабушкина А.В. Клиническая иммунология: учебное пособие. – Ростов-на-Дону: РостГМУ, 2014. [Tyukavkina SYu, Kharseeva GG, Labushkina AV. Klinicheskaya immunologiya: uchebnoe posobie. Rostov-na-Donu: RostGMU; 2014. (In Russ.)]
  5. Balashov D, Shcherbina A, Maschan M, et al. Center Experience of Unrelated and Haploidentical Stem Cell Transplantation with TCRab and CD19 Depletion in Children with Primary Immunodeficiency Syndromes. Biology Blood Marrow Transplant. 2015;21(11):1955-1962. https://doi.org/10.1016/j.bbmt.2015.07.008.
  6. Chrzanowska K, Gregorek H, Bozenna Dembowska-Baginska, et al. Nijmegen breakage syndrome (NBS). Orphanet J Rare Dis. 2012;7(1):13-20. https://doi.org/10.1186/1750-1172-7-13.
  7. Deripapa E, Balashov D, Rodina Y, et al. Prospective Study of a Cohort of Russian Nijmegen Breakage Syndrome Patients Demonstrating Predictive Value of Low Kappa-Deleting Recombination Excision Circle (KREC) Numbers and Beneficial Effect of Hematopoietic Stem Cell Transplantation (HSCT). Front Immunol. 2017;24(8):807. https://doi.org/10.3389/fimmu. 2017.00807.
  8. Halevy T, Akov S, Bohndorf M, et al. Chromosomal Instability and Molecular Defects in Induced Pluripotent Stem Cells from Nijmegen Breakage Syndrome Patients. Cell Rep. 2016;16(9):2499-2511. https://doi.org/10.1016/j.celrep.2016.07.071.
  9. Wolska-Kuśnierz B, Gregorek H, Chrzanowska K, et al. Nijmegen Breakage Syndrome: Clinical and Immunological Features, Long-Term Outcome and Treatment Options — a Retrospective Analysis. Clin Immunol. 2015;35(6):538-549. https://doi.org/10.1007/s10875-015-0186-9.
  10. Wen J, Cerosaletti K, Schultz KJ. NBN phosphorylation regulates the accumulation of MRN and ATM at sites of DNA double-strand breaks. Oncogene. 2013;32(37):4448-4456. https://doi.org/10.1038/onc.2012.443.

Copyright (c) 2020 Besedina E.A., Prometnoy D.V., Piskunova S.G., Selezneva O.S., Kharakhashyan L.E., Anchutin P.E.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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