Clinical and immunologic characteristics of GPS patients investigated for ALPS
| . | P1 . | P2 . | P3 . | P4 . | P5 . | P6 . |
|---|---|---|---|---|---|---|
| Age at investigation, y | 9 | 3 | 7 | 12 | 15 | 7 |
| Clinical | ||||||
| Cytopenia (nadir platelet count per microliter) | Thrombocytopenia (62 000) | Pancytopenia (47 000) | Thrombocytopenia (50 000) | Thrombocytopenia (55 000) | Thrombocytopenia (43 000) | Thrombocytopenia (35 000) |
| Autoantibodies | Anti-DNA, ANA | Anti-platelet, anti-tPA, ANA, anti-GBM, ANCA | — | — | — | ANA |
| Bleeding history | Mild gum bleeding | Mild gum bleeding | Mild epistaxis | Severe bleeding after 2 surgeries and after mucocutaneous injury | Severe bleeding after 2 surgeries | Mild bleeding |
| Splenomegaly | + | + | — | — | + | + |
| Lymphadenopathy | + (transient) | — | — | — | — | — |
| Other symptoms | — | Frequent infections | — | — | — | Chilblain lupus |
| Age at first symptom | 1 y 10 mo | 1 y 1 mo | >2 y | 1 mo | 4 y | 2 y 6 mo |
| Laboratory | ||||||
| IgG g/L* (normal age range, y) | 23.41 (5.04-14.74) | 10.46 (4.53-9.16) | 16.51 (5.04-14.74) | 10.6 (6.98-15.84) | 13.74 (6.98-15.84) | 18.2 (5.04-14.74) |
| DNT %† (<2.5%) | 2.8 (43/µL) | 1.7 (24/µL) | 2.4 (28/µL) | 1.5 (14/µL) | 2.3 (35/µL) | 5 (57/µL) |
| Vitamin B12,*,‡ mg/dL | 3 856 | >4 000 | >4 000 | 3 758 | 1 843 | >2 000 |
| sFASL,‡ pg/mL (<200) | 759 | 740 | 797 | 549 | 465 | 630 |
| IL-10, pg/mL (<20) | 6.5 | <1 | 4.7 | <1 | <1 | <1 |
| Genetic | ||||||
| NBEAL2 mutation | c.5299C>T p.Gln1767* homozygous | c.5299C>T p.Gln1767* homozygous | c.5299C>T p.Gln1767* homozygous | c.881C>G | c.881C>G | c.4501_4503del p.Leu1501del |
| p.Ser294* and c.958C>T p.Arg320Trp | p.Ser294* and c.958C>T p.Arg320Trp | |||||
| Both homozygous | Both homozygous |
| . | P1 . | P2 . | P3 . | P4 . | P5 . | P6 . |
|---|---|---|---|---|---|---|
| Age at investigation, y | 9 | 3 | 7 | 12 | 15 | 7 |
| Clinical | ||||||
| Cytopenia (nadir platelet count per microliter) | Thrombocytopenia (62 000) | Pancytopenia (47 000) | Thrombocytopenia (50 000) | Thrombocytopenia (55 000) | Thrombocytopenia (43 000) | Thrombocytopenia (35 000) |
| Autoantibodies | Anti-DNA, ANA | Anti-platelet, anti-tPA, ANA, anti-GBM, ANCA | — | — | — | ANA |
| Bleeding history | Mild gum bleeding | Mild gum bleeding | Mild epistaxis | Severe bleeding after 2 surgeries and after mucocutaneous injury | Severe bleeding after 2 surgeries | Mild bleeding |
| Splenomegaly | + | + | — | — | + | + |
| Lymphadenopathy | + (transient) | — | — | — | — | — |
| Other symptoms | — | Frequent infections | — | — | — | Chilblain lupus |
| Age at first symptom | 1 y 10 mo | 1 y 1 mo | >2 y | 1 mo | 4 y | 2 y 6 mo |
| Laboratory | ||||||
| IgG g/L* (normal age range, y) | 23.41 (5.04-14.74) | 10.46 (4.53-9.16) | 16.51 (5.04-14.74) | 10.6 (6.98-15.84) | 13.74 (6.98-15.84) | 18.2 (5.04-14.74) |
| DNT %† (<2.5%) | 2.8 (43/µL) | 1.7 (24/µL) | 2.4 (28/µL) | 1.5 (14/µL) | 2.3 (35/µL) | 5 (57/µL) |
| Vitamin B12,*,‡ mg/dL | 3 856 | >4 000 | >4 000 | 3 758 | 1 843 | >2 000 |
| sFASL,‡ pg/mL (<200) | 759 | 740 | 797 | 549 | 465 | 630 |
| IL-10, pg/mL (<20) | 6.5 | <1 | 4.7 | <1 | <1 | <1 |
| Genetic | ||||||
| NBEAL2 mutation | c.5299C>T p.Gln1767* homozygous | c.5299C>T p.Gln1767* homozygous | c.5299C>T p.Gln1767* homozygous | c.881C>G | c.881C>G | c.4501_4503del p.Leu1501del |
| p.Ser294* and c.958C>T p.Arg320Trp | p.Ser294* and c.958C>T p.Arg320Trp | |||||
| Both homozygous | Both homozygous |
ANA, anti-nuclear antibody; ANCA, anti-neutrophil cytoplasmic antibody; DNT, double-negative T cell; GBM, glomerular basement membrane; IgG, immunoglobulin G; IL, interleukin; tPA, tissue-type plasminogen activator; +, present; —, absent.
Age dependent.
Absolute numbers in parentheses.
Cutoff values associated with high probability of FAS mutation3 : vitamin B12, 1 255 pg/mL; sFASL, 560 pg/mL.