Natural history of infants with non-SCID T cell lymphopenia identified on newborn screen

CLINICAL IMMUNOLOGY(2022)

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摘要
Newborn screening (NBS) for severe combined immunodeficiency (SCID) can identify infants with non-SCID T cell lymphopenia (TCL). The purpose of this study was to characterize the natural history and genetic findings of infants with non-SCID TCL identified on NBS. We analyzed data from 80 infants with non-SCID TCL in the mid -Atlantic region between 2012 and 2019. 66 patients underwent genetic testing and 41 (51%) had identified genetic variant(s). The most common genetic variants were thymic defects (33%), defects with unknown mechanisms (12%) and bone marrow production defects (5%). The genetic cohort had significantly lower me-dian initial CD3+, CD4+, CD8+ and CD4/CD45RA+ T cell counts compared to the non-genetic cohort. Thirty-six (45%) had either viral, bacterial, or fungal infection; only one patient had an opportunistic infection (vaccine strain VZV infection). Twenty-six (31%) of patients had resolution of TCL during the study period.
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关键词
T cell lymphopenia (TCL), Newborn screening (NBS), T cell receptor excision circle (TREC), Severe combined immunodeficiency (SCID), Genetic testing, Varicella-zoster virus (VZV), Pneumocystis jirovecii pneumonia (PJP)
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