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Immunodeficiency 117(IMD117)

MedGen UID:
1848763
Concept ID:
C5882739
Disease or Syndrome
Synonyms: IMD117; IMMUNODEFICIENCY 117, MYCOBACTERIOSIS, AUTOSOMAL RECESSIVE
 
Gene (location): IRF1 (5q31.1)
 
Monarch Initiative: MONDO:0958011
OMIM®: 620668

Definition

Immunodeficiency-117 (IMD117) is an autosomal recessive immunologic disorder characterized by increased susceptibility to disseminated mycobacterial infection apparent in early childhood. Affected individuals develop mycobacterial disease after BCG (bacille Calmette-Guerin) vaccination and show increased susceptibility to other mycobacterial infections, such as M. avium. Immunologic workup shows impaired development of myeloid and lymphoid cell subsets that secrete and respond to gamma-interferon (IFNG; 147570) (et al., 2023). [from OMIM]

Clinical features

From HPO
Clubbing
MedGen UID:
57692
Concept ID:
C0149651
Anatomical Abnormality
Broadening of the soft tissues (non-edematous swelling of soft tissues) of the digital tips in all dimensions associated with an increased longitudinal and lateral curvature of the nails.
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Diarrhea
MedGen UID:
8360
Concept ID:
C0011991
Sign or Symptom
Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.
Hepatomegaly
MedGen UID:
42428
Concept ID:
C0019209
Finding
Abnormally increased size of the liver.
Intestinal malrotation
MedGen UID:
113153
Concept ID:
C0221210
Congenital Abnormality
An abnormality of the intestinal rotation and fixation that normally occurs during the development of the gut. This can lead to volvulus, or twisting of the intestine that causes obstruction and necrosis.
Anemia
MedGen UID:
1526
Concept ID:
C0002871
Disease or Syndrome
A reduction in erythrocytes volume or hemoglobin concentration.
Thrombocytopenia
MedGen UID:
52737
Concept ID:
C0040034
Disease or Syndrome
A reduction in the number of circulating thrombocytes.
Recurrent lower respiratory tract infections
MedGen UID:
756211
Concept ID:
C3163798
Disease or Syndrome
An increased susceptibility to lower respiratory tract infections as manifested by a history of recurrent lower respiratory tract infections.
Histoplasmosis
MedGen UID:
42468
Concept ID:
C0019655
Disease or Syndrome
Histoplasmosis is caused by the fungus Histoplasma capsulatum and is consider to be an opportunistic infection in immunosuppressed persons.
Leukopenia
MedGen UID:
6073
Concept ID:
C0023530
Disease or Syndrome
An abnormal decreased number of leukocytes in the blood.
Lymphadenitis
MedGen UID:
7410
Concept ID:
C0024205
Disease or Syndrome
Inflammation of a lymph node.
Pneumonia
MedGen UID:
10813
Concept ID:
C0032285
Disease or Syndrome
Inflammation of any part of the lung parenchyma.
Sinusitis
MedGen UID:
20772
Concept ID:
C0037199
Disease or Syndrome
Inflammation of the paranasal sinuses owing to a viral, bacterial, or fungal infection, allergy, or an autoimmune reaction.
Splenomegaly
MedGen UID:
52469
Concept ID:
C0038002
Finding
Abnormal increased size of the spleen.
Pustular rash
MedGen UID:
43222
Concept ID:
C0085641
Sign or Symptom
A rash composed of pustular lesions. A pustule is defined as a vesicle or bulla containing purulent material. It varies in size and may occur at different levels within the epidermis
Increased circulating IgA concentration
MedGen UID:
66800
Concept ID:
C0239984
Finding
An abnormally increased level of immunoglobulin A in blood.
Axillary lymphadenopathy
MedGen UID:
107913
Concept ID:
C0578735
Pathologic Function
Enlarged lymph node located in the axillary region (armpit).
Reduced natural killer cell count
MedGen UID:
383765
Concept ID:
C1855767
Finding
Less than normal number of natural killer cells, a type of lymphocyte in the innate immune system with an ability to mediate cytotoxicity and produce cytokines after the ligation of a germline-encoded activation receptor.
T lymphocytopenia
MedGen UID:
419385
Concept ID:
C2931322
Finding
An abnormally low count of T cells.
BCGosis
MedGen UID:
823215
Concept ID:
C3830467
Disease or Syndrome
Distant, or disseminated infection with Bacillus Calmette-Guerin (BCG) following vaccination associated with failure to contain thebacillus Calmette-Guerin (BCG) following vaccination leading to spread of BCG to many sites in the body. The tuberculosis vaccine BCG contains live attenuated Mycobacterium bovis.
Recurrent mycobacterial infections
MedGen UID:
869021
Concept ID:
C4023438
Finding
Increased susceptibility to mycobacterial infections, as manifested by recurrent episodes of mycobacterial infection.
Increased proportion of transitional B cells
MedGen UID:
892766
Concept ID:
C4072920
Finding
An elevation in the normal proportion of transitional B cells (CD19+/CD38high/IgMhigh) in circulation relative to the total number of B cells. B cells originate from precursors in the bone marrow, and the first cells which migrate to the peripheral blood have been classified as transitional B cells.
BCGitis
MedGen UID:
1684722
Concept ID:
C5139070
Disease or Syndrome
Local or regional infection with Bacillus Calmette-Guerin (BCG) following vaccination.
Nontuberculous mycobacterial pulmonary infection
MedGen UID:
1700174
Concept ID:
C5139228
Disease or Syndrome
An infection of the lung caused by environmental mycobacteria. Such infections can occur in individuals with predisposing lung disease or immune disease.
Disseminated nontuberculous mycobacterial infection
MedGen UID:
1687715
Concept ID:
C5139240
Disease or Syndrome
An infection with nontuberculous mycobacteria that affects multiple body sites. Such infections can occur in individuals with immune disease.
Decreased proportion of naive CD8 T cells
MedGen UID:
1694295
Concept ID:
C5139538
Finding
An abnormally reduced proportion of naive CD8 T cells relative to the total number of T cells.
Decreased proportion of central memory CD8-positive, alpha-beta T cells
MedGen UID:
1686898
Concept ID:
C5139550
Finding
A reduced proportion of CD8-positive, alpha-beta central memory T cells compared to the total number of T cells in the blood. These cells have the phenotype CCR7-negative, CD127-positive, CD45RA-negative, CD45RO-positive, and CD25-negative.
Increased proportion of effector memory CD8-positive, alpha-beta T cells
MedGen UID:
1690695
Concept ID:
C5139556
Finding
An increased proportion of effector memory CD8-positive, alpha-beta T cells compared to the total number of T cells in the blood. These cells have the phenotype CCR7-negative, CD127-positive, CD45RA-negative, CD45RO-positive, and CD25-negative.
Increased proportion of CD8-positive, alpha-beta TEMRA T cells
MedGen UID:
1717191
Concept ID:
C5398015
Finding
An increased proportion of CD8-positive, alpha-beta effector memory RA TEMRA T cells compared to the total number of T cells in the blood. These cells have the phenotype CD45RA-positive, CD45RO-negative, and CCR7-negative.
Fever
MedGen UID:
5169
Concept ID:
C0015967
Sign or Symptom
Body temperature elevated above the normal range.
Positive Mycobacterium avium sputum culture
MedGen UID:
1863476
Concept ID:
C5936862
Laboratory or Test Result
Growth of mycobacterium avium in a sputum culture.
Mediastinal lymphadenopathy
MedGen UID:
451062
Concept ID:
C0520743
Disease or Syndrome
Swelling of lymph nodes within the mediastinum, the central compartment of the thoracic cavities that contains the heart and the great vessels, the esophagus, and trachea and other structures including lymph nodes.
Cafe-au-lait spot
MedGen UID:
113157
Concept ID:
C0221263
Finding
Cafe-au-lait spots are hyperpigmented lesions that can vary in color from light brown to dark brown with smooth borders and having a size of 1.5 cm or more in adults and 0.5 cm or more in children.

Professional guidelines

PubMed

Abu-Rustum NR, Yashar CM, Arend R, Barber E, Bradley K, Brooks R, Campos SM, Chino J, Chon HS, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Gaillard S, Giuntoli R II, Glaser S, Holmes J, Howitt BE, Kendra K, Lea J, Lee N, Mantia-Smaldone G, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Rodabaugh K, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian N, Espinosa S
J Natl Compr Canc Netw 2024 Mar;22(2):117-135. doi: 10.6004/jnccn.2024.0013. PMID: 38503056
Lepère P, Milleliri JM
Med Sante Trop 2017 Jun 1;27(2):117-118. doi: 10.1684/mst.2017.0675. PMID: 28625945
Empson M, Sinclair J, O'Donnell J, Ameratunga R, Fitzharris P, Steele R; New Zealand Clinical Immunology Group
N Z Med J 2004 Jun 4;117(1195):U914. PMID: 15282626

Recent clinical studies

Etiology

Mitjà O, Alemany A, Marks M, Lezama Mora JI, Rodríguez-Aldama JC, Torres Silva MS, Corral Herrera EA, Crabtree-Ramirez B, Blanco JL, Girometti N, Mazzotta V, Hazra A, Silva M, Montenegro-Idrogo JJ, Gebo K, Ghosn J, Peña Vázquez MF, Matos Prado E, Unigwe U, Villar-García J, Wald-Dickler N, Zucker J, Paredes R, Calmy A, Waters L, Galvan-Casas C, Walmsley S, Orkin CM; SHARE-NET writing group
Lancet 2023 Mar 18;401(10380):939-949. Epub 2023 Feb 21 doi: 10.1016/S0140-6736(23)00273-8. PMID: 36828001
van Wyngaard A, Whiteside A
Afr J AIDS Res 2021 Jul;20(2):117-124. doi: 10.2989/16085906.2021.1948877. PMID: 34264162
Marra CM
Handb Clin Neurol 2018;152:117-122. doi: 10.1016/B978-0-444-63849-6.00009-8. PMID: 29604970
Cohen J, Torres C
Ageing Res Rev 2017 Jul;36:117-124. Epub 2016 Dec 23 doi: 10.1016/j.arr.2016.12.004. PMID: 28017881Free PMC Article
Vance DE, Randazza J, Fogger S, Slater LZ, Humphrey SC, Keltner NL
J Am Psychiatr Nurses Assoc 2014 Mar-Apr;20(2):117-24. doi: 10.1177/1078390314527549. PMID: 24717830

Diagnosis

Dian S, Ganiem AR, Ekawardhani S
Pathog Glob Health 2023 Feb;117(1):14-23. Epub 2022 Jun 11 doi: 10.1080/20477724.2022.2083977. PMID: 35694771Free PMC Article
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Marra CM
Handb Clin Neurol 2018;152:117-122. doi: 10.1016/B978-0-444-63849-6.00009-8. PMID: 29604970
Rahimian P, He JJ
Prog Neurobiol 2017 Oct;157:117-132. Epub 2016 Apr 12 doi: 10.1016/j.pneurobio.2016.04.003. PMID: 27084354Free PMC Article
Cimerman S, Cimerman B, Lewi DS
Sao Paulo Med J 1999 Nov 4;117(6):266-73. doi: 10.1590/s1516-31801999000600007. PMID: 10625890

Therapy

Leung E, Cottrell ML, Sykes C, White N, Kashuba ADM, Dumond JB
CPT Pharmacometrics Syst Pharmacol 2023 Dec;12(12):1922-1930. Epub 2023 Oct 9 doi: 10.1002/psp4.13042. PMID: 37814498Free PMC Article
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Cohen J, Torres C
Ageing Res Rev 2017 Jul;36:117-124. Epub 2016 Dec 23 doi: 10.1016/j.arr.2016.12.004. PMID: 28017881Free PMC Article
Vance DE, Randazza J, Fogger S, Slater LZ, Humphrey SC, Keltner NL
J Am Psychiatr Nurses Assoc 2014 Mar-Apr;20(2):117-24. doi: 10.1177/1078390314527549. PMID: 24717830
So CC, Wong KF
Br J Haematol 2002 Jun;117(4):777. doi: 10.1046/j.1365-2141.2002.03526.x. PMID: 12060110

Prognosis

Leung E, Cottrell ML, Sykes C, White N, Kashuba ADM, Dumond JB
CPT Pharmacometrics Syst Pharmacol 2023 Dec;12(12):1922-1930. Epub 2023 Oct 9 doi: 10.1002/psp4.13042. PMID: 37814498Free PMC Article
Schmidt A, Groh AM, Frick JS, Vehreschild MJGT, Ludwig KU
Dtsch Arztebl Int 2022 Feb 25;119(8):117-123. doi: 10.3238/arztebl.m2022.0105. PMID: 35101171Free PMC Article
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Mitsuyasu RT
Top HIV Med 2008 Oct-Nov;16(4):117-21. PMID: 18838745
Blockmans D, Vermylen J
Acta Clin Belg 1992;47(2):117-23. doi: 10.1080/17843286.1992.11718217. PMID: 1321536

Clinical prediction guides

Speidell A, Agbey C, Mocchetti I
Brain Behav Immun 2024 Mar;117:347-355. Epub 2024 Jan 22 doi: 10.1016/j.bbi.2024.01.215. PMID: 38266662Free PMC Article
Leung E, Cottrell ML, Sykes C, White N, Kashuba ADM, Dumond JB
CPT Pharmacometrics Syst Pharmacol 2023 Dec;12(12):1922-1930. Epub 2023 Oct 9 doi: 10.1002/psp4.13042. PMID: 37814498Free PMC Article
Gandhi M, Hickey M, Imbert E, Grochowski J, Mayorga-Munoz F, Szumowski JD, Oskarsson J, Shiels M, Sauceda J, Salazar J, Dilworth S, Nguyen JQ, Glidden DV, Havlir DV, Christopoulos KA
Ann Intern Med 2023 Jul;176(7):969-974. Epub 2023 Jul 4 doi: 10.7326/M23-0788. PMID: 37399555Free PMC Article
Tarín-Vicente EJ, Alemany A, Agud-Dios M, Ubals M, Suñer C, Antón A, Arando M, Arroyo-Andrés J, Calderón-Lozano L, Casañ C, Cabrera JM, Coll P, Descalzo V, Folgueira MD, García-Pérez JN, Gil-Cruz E, González-Rodríguez B, Gutiérrez-Collar C, Hernández-Rodríguez Á, López-Roa P, de Los Ángeles Meléndez M, Montero-Menárguez J, Muñoz-Gallego I, Palencia-Pérez SI, Paredes R, Pérez-Rivilla A, Piñana M, Prat N, Ramirez A, Rivero Á, Rubio-Muñiz CA, Vall M, Acosta-Velásquez KS, Wang A, Galván-Casas C, Marks M, Ortiz-Romero PL, Mitjà O
Lancet 2022 Aug 27;400(10353):661-669. Epub 2022 Aug 8 doi: 10.1016/S0140-6736(22)01436-2. PMID: 35952705Free PMC Article
Felgentreff K, Perez-Becker R, Speckmann C, Schwarz K, Kalwak K, Markelj G, Avcin T, Qasim W, Davies EG, Niehues T, Ehl S
Clin Immunol 2011 Oct;141(1):73-82. Epub 2011 May 30 doi: 10.1016/j.clim.2011.05.007. PMID: 21664875

Recent systematic reviews

Maccora I, Maniscalco V, Campani S, Carrera S, Abbati G, Marrani E, Mastrolia MV, Simonini G
Orphanet J Rare Dis 2023 May 13;18(1):117. doi: 10.1186/s13023-023-02721-6. PMID: 37179309Free PMC Article
Bagherzadeh-Fard M, Amin Yazdanifar M, Sadeghalvad M, Rezaei N
Int Immunopharmacol 2023 Apr;117:109366. Epub 2023 Mar 9 doi: 10.1016/j.intimp.2022.109366. PMID: 37012858
Íncera-Fernández D, Gámez-Guadix M, Moreno-Guillén S
Int J Environ Res Public Health 2021 Dec 17;18(24) doi: 10.3390/ijerph182413299. PMID: 34948907Free PMC Article
Ni JD, Xiong YZ, Wang XJ, Xiu LC
Int J STD AIDS 2013 Feb;24(2):117-22. Epub 2013 May 6 doi: 10.1177/0956462412472309. PMID: 23467291
Both JM, van Roosmalen J
BJOG 2010 Nov;117(12):1444-50. doi: 10.1111/j.1471-0528.2010.02692.x. PMID: 20937071

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