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Immunodeficiency 75(IMD75)

MedGen UID:
1741014
Concept ID:
C5436860
Disease or Syndrome
Synonym: IMMUNODEFICIENCY 75 WITH LYMPHOPROLIFERATION
 
Gene (location): TET2 (4q24)
 
Monarch Initiative: MONDO:0030858
OMIM®: 619126

Definition

Immunodeficiency-75 with lymphoproliferation (IMD75) is an autosomal recessive immunologic disorder characterized by immunodeficiency, immune dysregulation, and the development of lymphoproliferative disorders, including lymphoma. Affected individuals usually present in infancy with severe and recurrent infections, mainly viral and affecting the respiratory tract. Some patients may have autoimmune cytopenias, anemia, or thrombocytopenia. Patients also develop hepatosplenomegaly, lymphadenopathy, lymphoproliferative disorders, and various types of T- or B-cell lymphomas. Immunologic work-up shows decreased class-switched B cells, impaired B-cell terminal differentiation, and hypo- or hypergammaglobulinemia. There is skewed differentiation and dysregulation of T cells, as well as possibly disrupted hematopoiesis. Additional features include failure to thrive and global developmental delay. The phenotype may be reminiscent of ALPS (601859), including laboratory evidence of impaired Fas-dependent T-cell apoptosis. Although hematopoietic stem cell transplantation may be effective treatment, many patients die in childhood (summary by Stremenova Spegarova et al., 2020). [from OMIM]

Clinical features

From HPO
Lymphoma
MedGen UID:
44223
Concept ID:
C0024299
Neoplastic Process
A cancer originating in lymphocytes and presenting as a solid tumor of lymhpoid cells.
Hepatosplenomegaly
MedGen UID:
9225
Concept ID:
C0019214
Sign or Symptom
Simultaneous enlargement of the liver and spleen.
Moderate global developmental delay
MedGen UID:
500807
Concept ID:
C2237142
Finding
A moderate delay in the achievement of motor or mental milestones in the domains of development of a child.
Bronchiectasis
MedGen UID:
14234
Concept ID:
C0006267
Disease or Syndrome
Persistent abnormal dilatation of the bronchi owing to localized and irreversible destruction and widening of the large airways.
Recurrent respiratory infections
MedGen UID:
812812
Concept ID:
C3806482
Finding
An increased susceptibility to respiratory infections as manifested by a history of recurrent respiratory infections.
Lymphadenopathy
MedGen UID:
96929
Concept ID:
C0497156
Disease or Syndrome
Enlargement (swelling) of a lymph node.
Persistent EBV viremia
MedGen UID:
767466
Concept ID:
C3554552
Finding
Persistent presence of Epstein-Barr virus in the blood.
Follicular hyperplasia
MedGen UID:
863170
Concept ID:
C4014733
Finding
Lymphadenopathy (enlargement of lymph nodes) owing to hyperplasia of follicular (germinal) centers.
Decreased proportion of class-switched memory B cells
MedGen UID:
892709
Concept ID:
C4072925
Finding
A reduction in the normal proportion of class-switched memory B cells (CD19+/CD27+/IgM+/IgD+) relative to the total number of B cells. Marginal zone B cells undergo limited somatic hypermutation and produce high-affinity IgM and some IgG, whereas class-switched memory B cells synthetize IgG, IgM, and IgA.
Decreased FasL-mediated apoptosis
MedGen UID:
1788667
Concept ID:
C5539888
Cell or Molecular Dysfunction
A reduced amount of programmed cell death upon stimulation of the FAS receptor, which normally induces caspase-8 dependent apoptosis.

Professional guidelines

PubMed

Kennedy PG
J Neurol Neurosurg Psychiatry 2004 Mar;75 Suppl 1(Suppl 1):i10-5. doi: 10.1136/jnnp.2003.034280. PMID: 14978145Free PMC Article
Day JN, Lalloo DG
J Neurol Neurosurg Psychiatry 2004 Mar;75 Suppl 1(Suppl 1):i2-9. doi: 10.1136/jnnp.2003.034330. PMID: 14978144Free PMC Article
Brabin L
Acta Trop 2000 Feb 25;75(1):53-70. doi: 10.1016/s0001-706x(99)00093-5. PMID: 10708007

Recent clinical studies

Etiology

Uygun DFK, Uygun V, Başaran A, Kocatepe G, Kazlı T, Bingöl A
Int J Cancer 2025 Mar 1;156(5):964-968. Epub 2024 Oct 6 doi: 10.1002/ijc.35213. PMID: 39369446Free PMC Article
Kamau E, Chaudhury S, Bolton JS, Slike BM, Jian N, Eller MA, Eller LA, Ake J, Robb ML, Krebs SJ, Bergmann-Leitner ES
Clin Infect Dis 2022 Nov 14;75(10):1834-1837. doi: 10.1093/cid/ciac384. PMID: 35594548
Deeks SG, Overbaugh J, Phillips A, Buchbinder S
Nat Rev Dis Primers 2015 Oct 1;1:15035. doi: 10.1038/nrdp.2015.35. PMID: 27188527
Cham B, Bonilla MA, Winkelstein J
Semin Hematol 2002 Apr;39(2):107-12. doi: 10.1053/shem.2002.31916. PMID: 11957193
Minor P
Dev Biol (Basel) 2001;105:75-80. PMID: 11763340

Diagnosis

Matsuoka S, Adusei-Poku MA, Abana CZ, Duker EO, Bonney EY, Ofori SB, Parbie PK, Okazaki M, Kawana-Tachikawa A, Ishikawa K, Ampofo WK, Matano T
Jpn J Infect Dis 2022 Jul 22;75(4):395-397. Epub 2021 Dec 28 doi: 10.7883/yoken.JJID.2021.573. PMID: 34980705
Solomon DA
Infect Dis Clin North Am 2019 Sep;33(3):647-662. Epub 2019 Jun 22 doi: 10.1016/j.idc.2019.05.001. PMID: 31239091
Jose RJ, Faiz SA, Dickey BF, Brown JS
Br J Hosp Med (Lond) 2014 Dec;75(12):691-7. doi: 10.12968/hmed.2014.75.12.691. PMID: 25488532
Karthikeyan K
Indian J Dermatol Venereol Leprol 2009 Jul-Aug;75(4):340-7. doi: 10.4103/0378-6323.53128. PMID: 19584457
Baer JW
Gen Hosp Psychiatry 1987 Jan;9(1):75-6. doi: 10.1016/0163-8343(87)90106-x. PMID: 3817465

Therapy

Bacic Lima D, Solomon DA
Infect Dis Clin North Am 2024 Sep;38(3):409-422. Epub 2024 Jun 12 doi: 10.1016/j.idc.2024.04.002. PMID: 38871570
Giovannoni G, Soelberg Sorensen P, Cook S, Rammohan K, Rieckmann P, Comi G, Dangond F, Adeniji AK, Vermersch P
Mult Scler 2018 Oct;24(12):1594-1604. Epub 2017 Sep 5 doi: 10.1177/1352458517727603. PMID: 28870107
Deeks SG, Overbaugh J, Phillips A, Buchbinder S
Nat Rev Dis Primers 2015 Oct 1;1:15035. doi: 10.1038/nrdp.2015.35. PMID: 27188527
Roschewski M, Wilson WH
Best Pract Res Clin Haematol 2012 Mar;25(1):75-89. Epub 2012 Feb 5 doi: 10.1016/j.beha.2012.01.005. PMID: 22409825Free PMC Article
Tebas P, Powderly WG
Expert Opin Pharmacother 2000 Dec;1(7):1429-40. doi: 10.1517/14656566.1.7.1429. PMID: 11249476

Prognosis

Bassat Q, Blau DM, Ogbuanu IU, Samura S, Kaluma E, Bassey IA, Sow S, Keita AM, Tapia MD, Mehta A, Kotloff KL, Rahman A, Islam KM, Alam M, El Arifeen S, Gurley ES, Baillie V, Mutevedzi P, Mahtab S, Thwala BN, Tippett Barr BA, Onyango D, Akelo V, Rogena E, Onyango P, Omore R, Mandomando I, Ajanovic S, Varo R, Sitoe A, Duran-Frigola M, Assefa N, Scott JAG, Madrid L, Tesfaye T, Dessie Y, Madewell ZJ, Breiman RF, Whitney CG, Madhi SA; Child Health and Mortality Prevention Surveillance (CHAMPS) Network
JAMA Netw Open 2023 Jul 3;6(7):e2322494. doi: 10.1001/jamanetworkopen.2023.22494. PMID: 37494044Free PMC Article
Shamu T, Rohner E, Chokunonga E, Spoerri A, Mandiriri A, Chimbetete C, Egger M, Bohlius J, Borok M
Cancer Rep (Hoboken) 2022 Oct;5(10):e1597. Epub 2021 Dec 7 doi: 10.1002/cnr2.1597. PMID: 34873875Free PMC Article
Atalell KA, Birhan Tebeje N, Ekubagewargies DT
PLoS One 2018;13(5):e0197145. Epub 2018 May 22 doi: 10.1371/journal.pone.0197145. PMID: 29787596Free PMC Article
Garg RK
Acta Neurol Scand 2010 Aug;122(2):75-90. Epub 2010 Jan 6 doi: 10.1111/j.1600-0404.2009.01316.x. PMID: 20055767
Saharan S, Lodha R, Agarwal R, Deorari AK, Paul VK
Indian J Pediatr 2008 Apr;75(4):359-62. Epub 2008 May 18 doi: 10.1007/s12098-008-0039-0. PMID: 18536891

Clinical prediction guides

Uygun DFK, Uygun V, Başaran A, Kocatepe G, Kazlı T, Bingöl A
Int J Cancer 2025 Mar 1;156(5):964-968. Epub 2024 Oct 6 doi: 10.1002/ijc.35213. PMID: 39369446Free PMC Article
Sammet S, Touzeau-Römer V, Wolf E, Schenk-Westkamp P, Romano B, Gersbacher E, Kastenbauer U, Boesecke C, Rockstroh J, Scholten S, Schneeweiss S, Roider J, Seybold U
Infection 2023 Dec;51(6):1823-1829. Epub 2023 Aug 1 doi: 10.1007/s15010-023-02075-y. PMID: 37526898Free PMC Article
Asai N, Motojima S, Ohkuni Y, Matsunuma R, Nakashita T, Kaneko N, Mikamo H
Respir Investig 2022 Jul;60(4):522-530. Epub 2022 Apr 29 doi: 10.1016/j.resinv.2022.04.002. PMID: 35501264
Stohl W, Schwarting A, Okada M, Scheinberg M, Doria A, Hammer AE, Kleoudis C, Groark J, Bass D, Fox NL, Roth D, Gordon D
Arthritis Rheumatol 2017 May;69(5):1016-1027. Epub 2017 Apr 7 doi: 10.1002/art.40049. PMID: 28118533Free PMC Article
Bayoumi AM, Redelmeier DA
Med Decis Making 2000 Oct-Dec;20(4):404-12. doi: 10.1177/0272989X0002000404. PMID: 11059473

Recent systematic reviews

Wang W, Zhao S, Wu Y, Duan W, Li S, Li Z, Guo C, Wang W, Zhang T, Wu H, Huang X
JMIR Public Health Surveill 2023 Jul 27;9:e46767. doi: 10.2196/46767. PMID: 37498645Free PMC Article
Sultana ZZ, Hoque FU, Beyene J, Akhlak-Ul-Islam M, Khan MHR, Ahmed S, Hawlader DH, Hossain A
BMC Infect Dis 2021 Jan 11;21(1):51. doi: 10.1186/s12879-020-05749-2. PMID: 33430786Free PMC Article
Hemelaar J, Elangovan R, Yun J, Dickson-Tetteh L, Fleminger I, Kirtley S, Williams B, Gouws-Williams E, Ghys PD; WHO–UNAIDS Network for HIV Isolation Characterisation
Lancet Infect Dis 2019 Feb;19(2):143-155. Epub 2018 Nov 30 doi: 10.1016/S1473-3099(18)30647-9. PMID: 30509777
Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, Stone J, Cunningham EB, Trickey A, Dumchev K, Lynskey M, Griffiths P, Mattick RP, Hickman M, Larney S
Lancet Glob Health 2017 Dec;5(12):e1192-e1207. Epub 2017 Oct 23 doi: 10.1016/S2214-109X(17)30375-3. PMID: 29074409Free PMC Article
Prasad K, Singh MB, Ryan H
Cochrane Database Syst Rev 2016 Apr 28;4(4):CD002244. doi: 10.1002/14651858.CD002244.pub4. PMID: 27121755Free PMC Article

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