Presentation
Herein we present the clinical and pathologic findings for the first known case of X-linked lymphoproliferative disorder with visual symptoms at initial presentation. [ncbi.nlm.nih.gov]
Survivors may go on to develop an acquired hypogammaglobulinaema, red cell aplasia, aplastic anaemia or lymphomatoid granulomatosis. [ 2, 3 ] Presentation Patients present in childhood (mean age 3-5 years) with signs of EBV infection: Respiratory : pharyngitis [patient.info]
Here, we present a 4-year-old boy with typical features of ADEM, that is, sudden onset of ataxia, loss of speech, and mental status changes. [thieme-connect.com]
EBV-induced hemophagocytic lymphohistiocytosis (HLH) is a known presentation in XLP. In EBV-induced HLH in XLP, the brain imaging findings in the acute phase include a non specific pattern. [ruralneuropractice.com]
Entire Body System
- Infectious Mononucleosis
The EBV causes several disorders, including infectious mononucleosis. Also, natural killer cells do not function. [msdmanuals.com]
Thirty-four patients died of infectious mononucleosis, 8 had fatal infectious mononucleosis with immunoblastic sarcoma, 9 had depressed immunity following Epstein-Barr virus infection, and 8 developed lymphoma. [lymphedemapeople.com]
This X-linked immunodeficiency becomes evident when the patients are infected with Epstein Barr virus (EBV) and develop a fulminant form of infectious mononucleosis leading to a lymphoproliferative syndrome that is often fatal (X-linked lymphoproliferative [pesquisa.bvsalud.org]
Musculoskeletal
- Myalgia
[…] infection Experimental infection in human volunteers elucidated the natural history of B19 infection.33 ,44 After an incubation period of one week following intranasal inoculation, viraemia occurred on day 6, accompanied by a mild illness with pyrexia, myalgia [ard.bmj.com]
Workup
When a young patient presents with cotton wool spots, a thorough workup must be done, and immunologic disorders should be considered in the differential diagnosis. [ncbi.nlm.nih.gov]
Serum
- Hypogammaglobulinemia
In those who survive, hypogammaglobulinemia and oncohematologic diseases are frequently observed. [pesquisa.bvsalud.org]
[…] virus-induced lymphoproliferative disorder Immunology An X-linked or far less commonly AR–primary immunodeficiency disorder characterized by a defective immune response to EBV infection, resulting in severe, life-threatening infectious mononucleosis–IM, severe hypogammaglobulinemia–ergo [medical-dictionary.thefreedictionary.com]
Although hypogammaglobulinemia and malignant lymphoma were associated with longer survivals, no patient had been documented as living into the fifth decade of life. [lymphedemapeople.com]
Further medical history revealed that the patient received treatment for abdominal Burkitt lymphoma including intravenous immunoglobulins for hypogammaglobulinemia after administration of Rituximab. [thieme-connect.com]
Treatment
Better treatments are needed urgently. How could this research help? “We are in the laboratory stages of developing a new treatment for XLP,” says Dr Booth. [action.org.uk]
Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions . [patient.info]
There are several treatment options available for those with the disorder. [disability-benefits-help.org]
[…] stem cell transplant (HSCT). [5] However, depending on clinical features, less aggressive treatments may be adopted, particularly if a suitable donor for transplant is not available. [emedicine.medscape.com]
X-linked lymphoproliferative disease is a life-threatening condition that has few treatment options. [sciencedaily.com]
Prognosis
X-linked lymphoproliferative disorder typically presents as an Epstein-Barr virus-specific immune defect with a poor prognosis. [ncbi.nlm.nih.gov]
XLP is a disease with a poor prognosis. Over 70% of patients die by the age of 10 due to fatal infectious mononucleosis. [jstage.jst.go.jp]
Prognosis for those patients has dramatically improved over the decades due to improved lymphoma chemotherapy protocols. [6] Jin YY, Zhou W, Tian ZQ, Chen TX. [emedicine.medscape.com]
These include: Imaging A thorough medical history, including: The onset of symptoms The physical features of the disease The treatments attempted or required The prognosis Imaging test results, including MRIs and CT scans Blood test results, showing the [disabilitybenefitscenter.org]
Etiology
Intracranial aneurysm etiologies include atherosclerosis, hypertension, vasculopathy, trauma, drug abuse, neoplasm, and infection. [ajnr.org]
[…] lymphoproliferative disorder (XLP, Duncan syndrome) Nijmegen breakage syndrome (NBS) Hyper IgM syndrome Autoimmune lymphoproliferative syndrome (ALPS, Canale-Smith syndrome) Sites Dependent on the underlying disease Most commonly extranodal: GI tract, lung, CNS Etiology [pathologyoutlines.com]
Therefore the defect in XLP converts normally activating signals into inhibitory signals. [7, 8, 9, 10] An XLP syndrome caused by mutations in the inhibitor-of-apoptosis gene XIAP has also been reported. [11, 12] Etiology Mutations in the SH2D1A and XIAP [emedicine.medscape.com]
From an etiological standpoint, it has been reported that some patients with ocular lesions have had one or more infectious diseases, although a definite causative relationship remains unclear [41]. [journals.plos.org]
Assessment of pre-diagnosis biomarkers of immune activation and inflammation: insights on the etiology of lymphoma. J Proteome Res. 2011;10:113–19. [ncbi.nlm.nih.gov]
Epidemiology
[…] deficiency due to a primary immunodeficiency or immunoregulatory disorder ( WHO ) Usually extranodal Varies from polymorphous proliferation of lymphoid cells to diverse lymphomas Usually humoral (B cell) types but also cellular (T cell) types Usually EBV+ Epidemiology [pathologyoutlines.com]
SH2D1A gene mutations cause XLP1, and XIAP gene mutations cause XLP2. [13] Epidemiology X-linked lymphoproliferative (XLP) syndrome is rare. XLP1 is estimated to occur in about 1 in 1,000,000 males worldwide. [emedicine.medscape.com]
Study of the molecular epidemiology of B19 virus has shown variation of certain regions of the virus with time and geographical location and is increased in conditions where the virus persists and is allowed to undergo multiple rounds of replication, [ard.bmj.com]
The epidemiology of multiple myeloma. Hematol Oncol Clin North Am 1992;6:225–47.10.1016/S0889-8588(18)30341-1Search in Google Scholar 19. Sigurdardottir E, Turesson I, Lund SH, Lindqvist EK, Mailankody S, Korde N, et al. [degruyter.com]
Epidemiological evidence for causal relationship between Epstein-Barr virus and Burkitt's lymphoma from Ugandan prospective study. [frontiersin.org]
Pathophysiology
Pathophysiology X-linked lymphoproliferative (XLP) syndrome is characterized by a high susceptibility to severe infection with EBV. Hemophagocytic lymphohistiocytosis is the most common presenting feature. [emedicine.medscape.com]
Pathophysiology: In XLP syndrome, the most striking manifestation is that EBV triggers an initial episode of IM that causes death, usually by liver failure secondary to hepatic necrosis, in more than 50% of infected children. [lymphedemapeople.com]
The substantial progress in understanding the XLP pathophysiology was made with revealing the molecular basis of this immunodeficiency. [exp-oncology.com.ua]
The pathophysiological basis for the increased involvement of the conjunctiva in MALToma is also unclear and should be addressed in future studies. [journals.plos.org]
Prevention
This mutation causes reduced levels of XIAP and may prevent the immune system from controlling the viral infection. [sparks.org.uk]
Mutations in the gene impair the function of the SAP protein, result in an abnormally short protein is unstable or nonfunctional, or prevent any protein coding. [ivami.com]
Rituximab can help prevent severe EBV infection before transplantation. Click here for Patient Education NOTE: This is the Professional Version. [msdmanuals.com]
Rituximab can help prevent severe EBV infection before transplantation. Drug Name Select Trade Rituximab RITUXAN Click here for Patient Education NOTE: This is the Professional Version. [merckmanuals.com]