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Erschienen in: Journal of Clinical Immunology 8/2022

17.08.2022 | Original Article

SOCS1 Haploinsufficiency Presenting as Severe Enthesitis, Bone Marrow Hypocellularity, and Refractory Thrombocytopenia in a Pediatric Patient with Subsequent Response to JAK Inhibition

verfasst von: Thomas F. Michniacki, Kelly Walkovich, Lauren DeMeyer, Nadine Saad, Mark Hannibal, Matthew L. Basiaga, Kelly K. Horst, Smriti Mohan, Liang Chen, Kailey Brodeur, Yan Du, David Frame, Sandra Ngo, Jillian Simoneau, Noah Brown, Pui Y. Lee

Erschienen in: Journal of Clinical Immunology | Ausgabe 8/2022

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Abstract

Haploinsufficiency of suppressor of cytokine signaling 1 (SOCS1) is a recently discovered autoinflammatory disorder with significant rheumatologic, immunologic, and hematologic manifestations. Here we report a case of SOCS1 haploinsufficiency in a 5-year-old child with profound arthralgias and immune-mediated thrombocytopenia unmasked by SARS-CoV-2 infection. Her clinical manifestations were accompanied by excessive B cell activity, eosinophilia, and elevated IgE levels. Uniquely, this is the first report of SOCS1 haploinsufficiency in the setting of a chromosomal deletion resulting in complete loss of a single SOCS1 gene with additional clinical findings of bone marrow hypocellularity and radiologic evidence of severe enthesitis. Immunologic profiling showed a prominent interferon signature in the patient’s peripheral blood mononuclear cells, which were also hypersensitive to stimulation by type I and type II interferons. The patient showed excellent clinical and functional laboratory response to tofacitinib, a Janus kinase inhibitor that disrupts interferon signaling. Our case highlights the need to utilize a multidisciplinary diagnostic approach and consider a comprehensive genetic evaluation for inborn errors of immunity in patients with an atypical immune-mediated thrombocytopenia phenotype.
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Metadaten
Titel
SOCS1 Haploinsufficiency Presenting as Severe Enthesitis, Bone Marrow Hypocellularity, and Refractory Thrombocytopenia in a Pediatric Patient with Subsequent Response to JAK Inhibition
verfasst von
Thomas F. Michniacki
Kelly Walkovich
Lauren DeMeyer
Nadine Saad
Mark Hannibal
Matthew L. Basiaga
Kelly K. Horst
Smriti Mohan
Liang Chen
Kailey Brodeur
Yan Du
David Frame
Sandra Ngo
Jillian Simoneau
Noah Brown
Pui Y. Lee
Publikationsdatum
17.08.2022
Verlag
Springer US
Erschienen in
Journal of Clinical Immunology / Ausgabe 8/2022
Print ISSN: 0271-9142
Elektronische ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-022-01346-x

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