Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis

Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Meiping Lu [verfasserIn] Weizhong Gu [verfasserIn] Yuanjian Sheng [verfasserIn] Jingjing Wang [verfasserIn] Xuefeng Xu [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children

Übergeordnetes Werk:	In: Frontiers in Immunology - Frontiers Media S.A., 2011, 12(2021)
Übergeordnetes Werk:	volume:12 ; year:2021

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fimmu.2021.670312

Katalog-ID:	DOAJ014696509

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520			\|a Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS.
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allfields	10.3389/fimmu.2021.670312 doi (DE-627)DOAJ014696509 (DE-599)DOAJ21a0235c2850407989597c017124165a DE-627 ger DE-627 rakwb eng RC581-607 Meiping Lu verfasserin aut Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS. activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy Meiping Lu verfasserin aut Weizhong Gu verfasserin aut Yuanjian Sheng verfasserin aut Jingjing Wang verfasserin aut Xuefeng Xu verfasserin aut Xuefeng Xu verfasserin aut In Frontiers in Immunology Frontiers Media S.A., 2011 12(2021) (DE-627)657998354 (DE-600)2606827-8 16643224 nnns volume:12 year:2021 https://doi.org/10.3389/fimmu.2021.670312 kostenfrei https://doaj.org/article/21a0235c2850407989597c017124165a kostenfrei https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full kostenfrei https://doaj.org/toc/1664-3224 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2021
spelling	10.3389/fimmu.2021.670312 doi (DE-627)DOAJ014696509 (DE-599)DOAJ21a0235c2850407989597c017124165a DE-627 ger DE-627 rakwb eng RC581-607 Meiping Lu verfasserin aut Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS. activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy Meiping Lu verfasserin aut Weizhong Gu verfasserin aut Yuanjian Sheng verfasserin aut Jingjing Wang verfasserin aut Xuefeng Xu verfasserin aut Xuefeng Xu verfasserin aut In Frontiers in Immunology Frontiers Media S.A., 2011 12(2021) (DE-627)657998354 (DE-600)2606827-8 16643224 nnns volume:12 year:2021 https://doi.org/10.3389/fimmu.2021.670312 kostenfrei https://doaj.org/article/21a0235c2850407989597c017124165a kostenfrei https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full kostenfrei https://doaj.org/toc/1664-3224 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2021
allfields_unstemmed	10.3389/fimmu.2021.670312 doi (DE-627)DOAJ014696509 (DE-599)DOAJ21a0235c2850407989597c017124165a DE-627 ger DE-627 rakwb eng RC581-607 Meiping Lu verfasserin aut Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS. activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy Meiping Lu verfasserin aut Weizhong Gu verfasserin aut Yuanjian Sheng verfasserin aut Jingjing Wang verfasserin aut Xuefeng Xu verfasserin aut Xuefeng Xu verfasserin aut In Frontiers in Immunology Frontiers Media S.A., 2011 12(2021) (DE-627)657998354 (DE-600)2606827-8 16643224 nnns volume:12 year:2021 https://doi.org/10.3389/fimmu.2021.670312 kostenfrei https://doaj.org/article/21a0235c2850407989597c017124165a kostenfrei https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full kostenfrei https://doaj.org/toc/1664-3224 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2021
allfieldsGer	10.3389/fimmu.2021.670312 doi (DE-627)DOAJ014696509 (DE-599)DOAJ21a0235c2850407989597c017124165a DE-627 ger DE-627 rakwb eng RC581-607 Meiping Lu verfasserin aut Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS. activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy Meiping Lu verfasserin aut Weizhong Gu verfasserin aut Yuanjian Sheng verfasserin aut Jingjing Wang verfasserin aut Xuefeng Xu verfasserin aut Xuefeng Xu verfasserin aut In Frontiers in Immunology Frontiers Media S.A., 2011 12(2021) (DE-627)657998354 (DE-600)2606827-8 16643224 nnns volume:12 year:2021 https://doi.org/10.3389/fimmu.2021.670312 kostenfrei https://doaj.org/article/21a0235c2850407989597c017124165a kostenfrei https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full kostenfrei https://doaj.org/toc/1664-3224 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2021
allfieldsSound	10.3389/fimmu.2021.670312 doi (DE-627)DOAJ014696509 (DE-599)DOAJ21a0235c2850407989597c017124165a DE-627 ger DE-627 rakwb eng RC581-607 Meiping Lu verfasserin aut Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS. activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy Meiping Lu verfasserin aut Weizhong Gu verfasserin aut Yuanjian Sheng verfasserin aut Jingjing Wang verfasserin aut Xuefeng Xu verfasserin aut Xuefeng Xu verfasserin aut In Frontiers in Immunology Frontiers Media S.A., 2011 12(2021) (DE-627)657998354 (DE-600)2606827-8 16643224 nnns volume:12 year:2021 https://doi.org/10.3389/fimmu.2021.670312 kostenfrei https://doaj.org/article/21a0235c2850407989597c017124165a kostenfrei https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full kostenfrei https://doaj.org/toc/1664-3224 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2021
language	English
source	In Frontiers in Immunology 12(2021) volume:12 year:2021
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topic_facet	activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children Immunologic diseases. Allergy
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container_title	Frontiers in Immunology
authorswithroles_txt_mv	Meiping Lu @@aut@@ Weizhong Gu @@aut@@ Yuanjian Sheng @@aut@@ Jingjing Wang @@aut@@ Xuefeng Xu @@aut@@
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callnumber-first	R - Medicine
author	Meiping Lu
spellingShingle	Meiping Lu misc RC581-607 misc activated phosphoinositide 3-kinase δ syndrome misc immunodeficiency misc granulomatosis with polyangiitis misc PIK3CD gene misc children misc Immunologic diseases. Allergy Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis
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topic_title	RC581-607 Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis activated phosphoinositide 3-kinase δ syndrome immunodeficiency granulomatosis with polyangiitis PIK3CD gene children
topic	misc RC581-607 misc activated phosphoinositide 3-kinase δ syndrome misc immunodeficiency misc granulomatosis with polyangiitis misc PIK3CD gene misc children misc Immunologic diseases. Allergy
topic_unstemmed	misc RC581-607 misc activated phosphoinositide 3-kinase δ syndrome misc immunodeficiency misc granulomatosis with polyangiitis misc PIK3CD gene misc children misc Immunologic diseases. Allergy
topic_browse	misc RC581-607 misc activated phosphoinositide 3-kinase δ syndrome misc immunodeficiency misc granulomatosis with polyangiitis misc PIK3CD gene misc children misc Immunologic diseases. Allergy
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title	Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis
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title_full	Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis
author_sort	Meiping Lu
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author_browse	Meiping Lu Weizhong Gu Yuanjian Sheng Jingjing Wang Xuefeng Xu
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title_sort	case report: activating pik3cd mutation in patients presenting with granulomatosis with polyangiitis
callnumber	RC581-607
title_auth	Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis
abstract	Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS.
abstractGer	Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS.
abstract_unstemmed	Activated phosphoinositide 3-kinase δ syndrome (APDS) is an autosomal dominant primary immunodeficiency caused by gain-of-function (GOF) mutations in PIK3CD or PIK3R1 genes. The phenotypes of APDS are highly variable, ranging from asymptomatic adults to profound immunodeficiency causing early death in childhood. Herein, we reported two pediatric patients with APDS presented with recurrent lung infections, sinusitis, hematuria, and positive anti-neutrophil cytoplasmic antibody (ANCA), previously diagnosed as granulomatosis with polyangiitis (GPA). Bronchoscopy showed mucosal nodule lymphoid hyperplasia in the entire airway. Many inflammatory cells infiltrated around the airway and in the lung parenchyma, and numbers of CD3+ T cells and CD20+ B cells were significantly increased, especially CD3+ T cells. Whole exome sequencing showed that they had the E1021K (c.3061 G >A) mutation in the PIK3CD gene. These are the first reported cases of APDS presenting as childhood-onset GPA. Pediatricians should suspect of APDS in the differential diagnosis of children who present with GPA-like symptoms. Additionally, timely and repeated bronchoscopies could contribute to providing an important diagnostic clue for APDS.
collection_details	GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700
title_short	Case Report: Activating PIK3CD Mutation in Patients Presenting With Granulomatosis With Polyangiitis
url	https://doi.org/10.3389/fimmu.2021.670312 https://doaj.org/article/21a0235c2850407989597c017124165a https://www.frontiersin.org/articles/10.3389/fimmu.2021.670312/full https://doaj.org/toc/1664-3224
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up_date	2024-07-04T00:08:11.274Z
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