2012, Number 3
<< Back Next >>
Rev Cubana Hematol Inmunol Hemoter 2012; 28 (3)
Hyper IgE syndrome. A case report
de la Guardia-Peña OM, Ustáriz-García CR, García-García MA, Morera-Barrios LM
Language: Spanish
References: 14
Page: 299-305
PDF size: 66.90 Kb.
ABSTRACT
Hyper IgE syndrome is a rare immunodeficiency initially described by Buckley in 1971. From 1972 to 2008, approximately 250 cases have been reported worldwide. Its clinical diagnosis is established through Grimbacher criteria and prognosis depends on timely diagnosis and treatment. A male patient aged 60, mestizo, with a history of having received surgical treatment of cervical spondylotic myelopathy more than 15 years ago is presented. In 1995, he also had a stroke and essential hypertension treatment. From his early ages he had multiple deep skin abscesses which were surgically removed; he also had several pneumonias that began in youth, as well as history of skin eczema that evolved by crises from severe to mild. This patient has a characteristic facies: broad nasal bridge, fleshy nose, prominent forehead. Due to this patient's history, the high dosage of IgE, high eosinophil count and the delay in the opsonophagocytic index, he was diagnosed as hyper IgE syndrome. He was treated with immunomodulators, parenteral B complex vitamin therapy, cimetidine, vitamin C in high doses and antihistamines. Clinical improvement of the initial condition was achieved after one year follow-up.
REFERENCES
Buckley R. Disorders of the IgE system. En: Stiehm ER, editor. Immunologic disorders in infants and children. 4th ed. Philadelphia: WB Saunders: 1996. p. 409-22.
Hsu CT, Lin YT, Yang YH, Chiang BL. The hyperimmunoglobulin E syndrome. J Microbiol Inmunol Infect. 2004 Apr;37(2):121-3. PMID:15181495.
Holland S, DeLeo FR, Elloumi HZ, Hsu AP, Uzel G, Brodsky N, et al. STAT 3 mutations in the hyper IgE syndrome. N Engl J Med. 2007 Oct;357(16):1608-19. PMID:17881745.
Vega C, Hernández L, Segura NH, Torres BA. Síndrome de hiper IgE. Diagnóstico y manejo oportunos. Revista Alergia México. 2008;55(1):38-45.
Grimbacher B, Holland SM, Puck JM. Hyper IgE syndrome. Immunol Rev. 2005 Feb;203:244-50. PMID:15661034.
Grimbacher B, Holland S, 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 Mar;340(9):692-702. PMID:10053178.
Freeman AF, Collura-Burke CJ, Patronas NJ, Satana-Ilcus L, Darnell D, Davis J, et al. Brain abnormalities in patients with Hyper immunoglobulin IgE Syndrome. Paediatrics. 2007 May;119(5):e1121-5.
Erlewyn-Lajeunesse MD. Hyperimmunoglobulin-E syndrome with recurrent infection: a review of current opinion andtreatment. Paediatric Allergy Inmunol. 2000 Aug(3);11:133-41.
Pearlman DS. Pathophysiology of the inflammatory response. J Allergy Clin Immunol. 1999 Oct ;104(4 Pt 1):S132-7.
DeWitt CA, Bishop AB, Buescher LS, Stone SP. Hyper immunoglobulin E syndrome: two cases and review of the literature. J Am Acad Dermatol. 2006 May;54(5):855-65. PMID:16635666.
D'Alessandro V, Pérez N. Diagnóstico temprano del síndrome de hiper IgE: un desafío. Arch Argent Pediat. 2004 Ago;102(4):290-5. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0325-00752004000400010&lng=es
O'Connell AC, Puck JM, Grimbacher B, Facchetti F, Majorana A, Gallin JI, et al. Delayed eruption of permanent teeth in hyperimmunoglobulinemia E recurrent infection syndrome. Oral Surg Oral Med Endod. 2000 Feb; 89(2):177-85. PMID: 10673653.
Grimbacher B, Schäffer AA, Holland SM, Davis J, Gallin JI, Malech HL, et al. Genetic linkage of Hyper-IgE syndrome to cromosome 4. Am J Hum Genet. 1999 Sep;65(3):735-44. PMID:10441580.
Stiehm ER. Cytokine dysregulation in the hyperimmunoglobulinemia E syndrome. J Pediatr. 2000 Feb;136(2):141-3. PMID:10657814.