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Fatal adult-onset antibody deficiency syndrome in a patient with cartilage hair hypoplasia.
[omenn syndrome]
Cartilage
hair
hypoplasia
(
CHH
)
is
an
autosomal
recessive
disorder
caused
by
mutations
in
the
ribonuclease
mitochondrial
RNA-processing
(
RMRP
)
gene
.
Although
its
most
constant
feature
is
metaphyseal
dysplasia
with
short
stature
,
CHH
is
associated
with
extraskeletal
defects
such
as
thin
hair
,
anemia
,
immunodeficiency
,
and
increased
incidence
of
lymphomas
.
The
spectrum
of
immunologic
phenotypes
in
CHH
translates
into
clinical
severity
.
Whereas
T
-
cell
deficiency
may
remain
subclinical
or
may
result
in
severe
combined
immunodeficiency
or
Omenn
syndrome
,
humoral
immunodeficiency
has
only
rarely
been
noted
in
these
patients
.
Here
we
report
the
diagnosis
of
CHH
in
a
woman
who
presented
with
severe
short
stature
and
a
full-blown
antibody
deficiency
,
clinically
resembling
common
variable
immunodeficiency
.
Sequencing
of
the
RMRP
gene
revealed
compound
heterozygosity
for
two
novel
mutations
(
g
.
68
_
69
delinsTT
and
g
.
76
C
>
T
)
.
Despite
the
late
onset
of
immunodeficiency
in
the
patient
,
its
clinical
course
was
severe
,
and
the
patient
died
3
years
after
the
first
diagnosis
.
Diseases
Validation
Diseases presenting
"chh is associated with extraskeletal defects such as thin hair"
symptom
omenn syndrome
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