2009, Número 6
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Bol Med Hosp Infant Mex 2009; 66 (6)
Síndrome de hiperinmunoglobulinemia E. Reporte de dos casos
Puebla-Miranda M, Martínez-Luna E, Vega-Memije ME
Idioma: Español
Referencias bibliográficas: 34
Paginas: 545-552
Archivo PDF: 858.50 Kb.
RESUMEN
Introducción. El síndrome de hiperinmunoglobulinemia E es una inmunodeficiencia sistémica poco frecuente, caracterizada por dermatitis eccematosa, abscesos fríos recurrentes, infecciones pulmonares con formación de neumatoceles, facies tosca, niveles elevados de inmunoglobulina E (IgE) en suero y eosinofilia.
Casos clínicos. Caso 1. Femenino de 11 años de edad con antecedentes de neumonía recurrente, gastroenteritis de repetición, dermatitis eccematosa de predominio en pliegues, y abscesos fríos; en estudios de laboratorio destacó el hallazgo de 16 070 eosinófilos e IgE de 4 864 UI. Manejada con gammaglobulina se observó buena respuesta clínica. Caso 2. Femenino de 12 años de edad con historia de otitis recurrente y conjuntivitis supurativa, presentaba eccema crónico generalizado e impetiginizado. En estudios de laboratorio se reportó IgE de 3 000 UI; fue manejada con dapsona, trimetropim/sulfametoxazol y metotrexate.
Conclusión. Los 2 casos aquí informados presentaron piel eccematosa, infecciones recurrentes e incremento de los niveles de IgE, compatibles con síndrome de hiperinmunoglobulinemia E en la forma autosómica recesiva.
REFERENCIAS (EN ESTE ARTÍCULO)
Davis SD, Schaller J, Wedgwood RJ. Job´s syndrome: recurrent, “cold”, staphylococcal abscesses. Lancet 1966;1:1013-1015.
Buckley RH, Wray BB, Elmaker EZ. Extreme hyperimmunoglobulinemia E and undue susceptibility to infection. Pediatrics 1972;49:69-70.
De Witt CA, Bishop AB, Buescher L, Stone S. Hyperimmunoglobulin E syndrome: Two cases and review of the literature. J Am Acad Dermatol 2006;54:855-865.
Grimbacher B, Holland SM, Gallin JI, Greenberg F, Hill SC, Malech HL, et al. Hyper-IgE syndrome with recurrent infections. An autosomal dominant multisystem disorder. N Engl J Med 1999;340:692-702.
Renner ED, Puck J, Holland S, Schmitt M, Weiss M, Frosch M, et al. Autosomal recessive hyperimmunoglobulin E syndrome: A distinct disease entity. J Pediatr 2004;144:93-99.
Verma S, Wollina U. Job´s syndrome-a case report. JEADV 2003;17:711-714.
Minegishi Y, Karasuyama H. Genetic origins of hyper-IgE syndrome. Curr Allergy Asthma Rep 2008;8:386-391.
Holland S, DeLeo F, Elloumi H, Hsu A, Uzel G, Brodsky N, et al. STAT3 Mutations in the hyper-IgE syndrome. N Engl J Med 2007;357:1608-1619.
Paulson M, Freeman A, Holland S. Hyper IgE syndrome: an update on clinical aspects and the role of signal transducer and activator of transcription 3. Curr Opin Allergy Clin Immunol 2008;8:527-533.
Jiao H, Toth B, Erdos M, Fransson I, Rakoczi E, Balogh I, et al. Novel and recurrent STAT3 mutations in hyper-IgE syndrome patients from different ethnic groups. Mol Immunol 2008;46:202-206.
Milner JD, Brenchley JM, Laurence A, Freeman AF, Hill BJ, Elias KM, et al. Impared T(H)17 cell differentiation in subjects with autosoman dominant hyper-IgE syndrome. Nature 2008;452:773-776.
Vargas L, Rodríguez M, Forero C, Montoya F, Montoya C, Sorensen R, et al. Increase in granulocyte-macrophage-colony-stimulating factor secretion and the respiratory burst with decreased L-selectin expression in hyper-IgE syndrome patients. Ann Allergy Asthma Immunol 1999;83:245-251.
Stiehm E. Cytokine dysregulation in the hyperimmunoglobulinemia E syndrome. J Pediatr 2000;136:141-143.
Speckmann C, Enders A, Woellner C, Thiel D, Rensing-Ehl A, Schlesier M, et al. Reduced memory B cell in patient with hyper IgE syndrome. Clin Immunol 2008;129:448-454.
Freeman A, Holland S. The hyper-IgE syndromes. Immunol Allergy Clin North Am 2008;28:277-291.
Chamlin S, McCalmont T, Cunningham B, Esterly N, Lai C, Mallory S, et al. Cutaneous manifestations of hyper-IgE syndrome in infants and children. J Pediatr 2002;141:572-575.
Borges W, Hensley T, Carey J, Petrak B, Hill H. The face of Job. J Pediatr 1998;133:303-305.
Eberting CL, Davis J, Puck J, Holland S, Turner M. Dermatitis and the newborn rash of hyper-IgE syndrome. Arch Dermatol 2004;140:1119-125.
Kamei R, Honig P. Neonatal Job’s syndrome featuring a vesicular eruption. Pediatr Dermatol1988;5:75-82.
Erlewin-Lajeunesse M. Hyperimmunoglobulin-E syndrome with recurrent infection: a review of current opinion and treatment. Pediatr Allergy Immunol 2000;11:133-141.
Freeman AF, Domingo DL, Holland SM. Hyper IgE (Job’s) syndrome: a primary immune deficiency with oral manifestations. Oral Dis 2009;15:2-7.
Aldous J, Olson G, Parkin M. Dental observations of hyper IgE disorder. J Clin Pediatr Dent 2007;32:69-72.
Hattori K, Hasui M, Masuda K, Masuda M, Ogino H, Kobayashi Y. Successful trimethoprim-sulfamethoxazole therapy in a patient with hyperimmunoglobulin E syndrome. Acta Paediatr 1993;82:324-326.
Tanaka H, Ito R, Onodera N, Waga S. Efficacy of long-term sulfamethoxazole-trimethoprim therapy in a boy with hyperimmunoglobulin E syndrome. Tohoku J Exp Med 1998;186:61-66.
Wakim M, Alazard M, Yajima A, Speight D, Saxon A, Stiehm R. High dose intravenous immunoglobin in atopic dermatitis and hyper-IgE syndrome. Ann Allergy Asthma Immunol 1998;81:153-158.
Kimata H. High-dose intravenous g-globulin treatment for hyperimmunoglobulin E syndrome. J Allergy Clin Immunol 1995;95:771-774.
Jeppson J, Jaffe H, Hill H. Use of recombinant human interferon gamma to enhance neutrophil chemotactic responses in Job’s syndrome of hyperimmunoglobulinemia E and recurrent infections. J Pediatr 1991;118:383-387.
Shuttleworth D, Holt P, Mathews N. Hyperimmunoglobulin E syndrome: Treatment with isotretinoin. Br J Dermatol 1988;119:93-99.
Orozco C, Velázquez L, Méndez N, Augusto B, Salazar T. Hyper IgE syndrome. Opportune diagnosis and management. Rev Alerg Mex 2008;55:38-45.
Lin SJ, Huang JL, Hsieh KH. Hodgkin’s disease in a child with hyperimmunoglobulin E syndrome. Pediatr Hematol Oncol 1998;15:451-454.
Bale J, Wilson J, Hill H. Fatal histiocytic lymphoma of the brain associated with hyperimmunoglobulin-E and recurrent infections. Cancer 1977;39:2386-2390.
Gorin L, Jeha S, Sullivan M. Burkitt´s lymphoma developing in a 7 year-old boy with hyper-IgE syndrome. J Allergy Clin Immunol 1989;83:5-10.
Onal I, Kurt M, Altundag K, Aksoy S, Dincer M, Gullu I. Peripheral T-cell lymphoma and Job’s syndrome: a rare association. Med Oncol 2006;23:141-144.
Amlot P, Green L. Atopy and immunoglobulin E concentrations in Hodgkin’s disease and other lymphomas. BMJ 1978;1:327-329.