Familial data, mutation data, and clinical findings in patients with biallelic RAB27A and UNC13D mutations
. | RAB27A (GS2) . | UNC13D (FHL3) . | |||||
---|---|---|---|---|---|---|---|
Patient 1 . | Patient 2 . | Patient 3 . | Patient 4 . | Patient 5 . | Patient 6 . | Patient 7 . | |
Origin | Sweden | Sweden | Pakistan | Pakistan | The Netherlands | Denmark | Poland |
Consanguinity | No | No | Yes | Yes | No | No | No |
Sex | Female | Female | Female | Male | Female | Female | Female |
Mutation | c.239G→C c.550C→T | c.239G→C c.550C→T | c.240-2A→C (homozygous) | c.1145G→A (homozygous) | c.247C→T c.754-2A→G | c.1389+1G→A c.2477_2480delTCAC | c.753+1G→T (homozygous) |
Protein alteration | Splice error R184X | Splice error R184X | Splice error | W382X | R83X splice error | Splice error L826QfsX20 | Splice error |
Age at HLH diagnosis | 2 mo | 2 mo | 13 y | 2 mo | 1 mo | 2 mo | 7 mo |
Fever (> 38°C) | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Splenomegaly | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Hepatomegaly | Yes | Yes | No | Yes | Yes | Yes | Yes |
Hemoglobin, g/L | 46 | 62 | 81 | 52 | 79 | — | 82 |
Neutrophils, 109/L | 0.7 | 0.3 | 2.0 | 0.2 | 0.7 | — | 0.3 |
Platelets, 109/L | 10 | 85 | 53 | 5 | 9 | — | 2 |
Triglycerides, mmol/L | 3.6 | 3.3 | ND | 3.3 | 4.2 | — | 3.7 |
Fibrinogen, g/L | ND | ND | 1.9 | 0.6 | ND | ND | 0.6 |
Ferritin, μg/L | 2293 | 1596 | 940 | 19 914 | 12 160 | — | 594 |
Hemophagocytosis | ND | ND | No | Yes (spleen) | No | Yes (BM) | Yes (BM) |
sCD25, U/mL | ND | ND | ND | ND | 8350 | ND | ND |
Decreased NK-cell activity | Borderline* | Yes | Borderline† | Yes | Yes | Yes | Yes |
Neurologic disease‡ | Yes | No | Yes | Yes | Yes | Yes | Yes |
Treatment protocol | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | HLH 2004 | HLH-2004 |
Remission at 2 mo | No | No | No | ND | No | Yes | Yes |
HSCT | Yes | Yes | Yes | Yes | Yes | Yes | No |
Outcome | Alive | Alive | Alive | Dead | Alive | Dead | Dead |
. | RAB27A (GS2) . | UNC13D (FHL3) . | |||||
---|---|---|---|---|---|---|---|
Patient 1 . | Patient 2 . | Patient 3 . | Patient 4 . | Patient 5 . | Patient 6 . | Patient 7 . | |
Origin | Sweden | Sweden | Pakistan | Pakistan | The Netherlands | Denmark | Poland |
Consanguinity | No | No | Yes | Yes | No | No | No |
Sex | Female | Female | Female | Male | Female | Female | Female |
Mutation | c.239G→C c.550C→T | c.239G→C c.550C→T | c.240-2A→C (homozygous) | c.1145G→A (homozygous) | c.247C→T c.754-2A→G | c.1389+1G→A c.2477_2480delTCAC | c.753+1G→T (homozygous) |
Protein alteration | Splice error R184X | Splice error R184X | Splice error | W382X | R83X splice error | Splice error L826QfsX20 | Splice error |
Age at HLH diagnosis | 2 mo | 2 mo | 13 y | 2 mo | 1 mo | 2 mo | 7 mo |
Fever (> 38°C) | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Splenomegaly | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Hepatomegaly | Yes | Yes | No | Yes | Yes | Yes | Yes |
Hemoglobin, g/L | 46 | 62 | 81 | 52 | 79 | — | 82 |
Neutrophils, 109/L | 0.7 | 0.3 | 2.0 | 0.2 | 0.7 | — | 0.3 |
Platelets, 109/L | 10 | 85 | 53 | 5 | 9 | — | 2 |
Triglycerides, mmol/L | 3.6 | 3.3 | ND | 3.3 | 4.2 | — | 3.7 |
Fibrinogen, g/L | ND | ND | 1.9 | 0.6 | ND | ND | 0.6 |
Ferritin, μg/L | 2293 | 1596 | 940 | 19 914 | 12 160 | — | 594 |
Hemophagocytosis | ND | ND | No | Yes (spleen) | No | Yes (BM) | Yes (BM) |
sCD25, U/mL | ND | ND | ND | ND | 8350 | ND | ND |
Decreased NK-cell activity | Borderline* | Yes | Borderline† | Yes | Yes | Yes | Yes |
Neurologic disease‡ | Yes | No | Yes | Yes | Yes | Yes | Yes |
Treatment protocol | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | HLH 2004 | HLH-2004 |
Remission at 2 mo | No | No | No | ND | No | Yes | Yes |
HSCT | Yes | Yes | Yes | Yes | Yes | Yes | No |
Outcome | Alive | Alive | Alive | Dead | Alive | Dead | Dead |