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Severe combined immunodeficiency in Serbia and Montenegro between years 1986 and 2010: a single-center experience.
[omenn syndrome]
Severe
combined
immunodeficiency
(
SCID
)
,
including
the
'
variant
'
Omenn
syndrome
(
OS
)
,
represent
a
heterogeneous
group
of
monogenic
disorders
characterized
by
defect
in
differentiation
of
T
-
and
/
or
B
lymphocytes
and
susceptibility
to
infections
since
birth
.
In
the
period
of
25
years
,
between
January
1986
and
December
2010
,
a
total
of
21
patients
(
15
SCID
,
6
OS
)
were
diagnosed
in
Mother
&
Child
Health
Institute
of
Serbia
,
a
tertiary-care
teaching
University
hospital
and
a
national
referral
center
for
patients
affected
with
primary
immunodeficiency
(
PID
)
.
The
diagnoses
were
based
on
anamnestic
data
,
clinical
findings
,
and
immunological
and
genetic
analysis
.
The
median
age
at
the
onset
of
the
first
infection
was
the
2nd
month
of
life
.
Seven
(
33
%
)
patients
had
positive
family
history
for
SCID
.
Out
of
five
male
infants
with
T
-B
+
NK-
SCID
phenotype
,
mutation
analysis
revealed
interleukin-
2
(
common
)
gamma-chain
receptor
(
IL
2
RG
)
mutations
in
3
with
positive
X-
linked
family
history
,
and
Janus-kinase
(
JAK
)
-
3
gene
defects
in
the
other
two
.
Six
patients
had
T
-B-NK
+
SCID
phenotype
and
further
6
features
of
OS
,
11
of
which
had
recombinase-activating
gene
(
RAG
1
or
RAG
2
)
and
1
Artemis
gene
mutations
.
One
child
with
T
+
B
+
NK
+
SCID
phenotype
as
well
had
proven
RAG
mutation
.
One
child
each
with
T
-B
+
NK
+
SCID
phenotype
,
CD
8
lymphopenia
and
unknown
phenotype
remained
without
known
underlying
genetic
defect
.
Of
the
eight
patients
who
underwent
hematopoetic
stem
cell
transplant
(
HSCT
)
5
survived
,
the
other
13
died
between
2
days
and
12
months
after
diagnosis
was
made
.
Early
diagnosis
of
SCID
,
before
onset
of
severe
infections
,
offers
possibility
for
HSCT
and
cure
.
Education
of
primary
-care
pediatricians
,
in
particular
including
awareness
of
the
risk
of
using
live
vaccines
and
non-irradiated
blood
products
,
should
improve
prognosis
of
SCID
in
our
setting
.
Diseases
Validation
Diseases presenting
"early diagnosis"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
alexander disease
allergic bronchopulmonary aspergillosis
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dentin dysplasia
dentinogenesis imperfecta
dracunculiasis
erdheim-chester disease
erythropoietic protoporphyria
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
locked-in syndrome
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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