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Mémoire de Maîtrise
DOI
https://doi.org/10.11606/D.42.2011.tde-09022012-124352
Document
Auteur
Nom complet
Stefanie Gomes Klaver
Unité de l'USP
Domain de Connaissance
Date de Soutenance
Editeur
São Paulo, 2011
Directeur
Jury
Condino Neto, Antonio (Président)
Barbuto, Jose Alexandre Marzagao
Barros, Myrthes Anna Maragna Toledo
Titre en portugais
Defeitos genético-moleculares e aspectos clínicos de pacientes com síndrome de hiper IgM autossômica.
Mots-clés en portugais
Genética molecular
Imunogenética
Mutação genética
Resumé en portugais
A síndrome de HIGM é uma imunodeficiência, caracterizada por níveis séricos normais ou elevados de IgM associados com baixos níveis de IgG, IgA e IgE. Neste estudo investigamos pacientes com HIGM autossômico recessivo. Selecionamos 15 pacientes com diagnóstico clínico sugestivo de AR-HIGM, 10 do sexo feminino, 05 do sexo masculino, onde onze são brasileiros, um é francês e três são turcos, com idades que variam de 2 a 40 anos. Todos os pacientes apresentam infecções recorrentes: 100% pneumonias, 80% otites médias agudas, 53% sinusites, 46% amigdalites, 40% diarréias 26% infecções urinárias, uma apresentou micobacteriose cutânea. Encontramos as seguintes mutações no gene AICDA: Pacientes EJ e GF, mutação missense na base 260 do cDNA (c.260G>C; p. Cys87Ser). Pacientes DA e RC apresentam defeito de splice, acarretando na deleção total do exon 4 do gene AICDA. Os pacientes estrangeiros foram previamente estudados para os genes AICDA, UNG e CD40, e nenhuma alteração foi encontrada. Neste caso, estudamos o gene INO80, e encontramos nos exons 04 (g.24012 G>A) e 26 (g.99976 G>T) do gene INO80, duas mutações missense em heterozigose no DNAg do paciente OD. O estudo molecular e genético é importante para a realização do diagnóstico diferencial, estratégia terapêutica e prognóstico dos casos.
Titre en anglais
Molecular-genetic defects and clinical spectrum of autosomal hyper IgM syndrome in Brazilian patients.
Mots-clés en anglais
Genetic mutation
Immunogenetics
Molecular genetics
Resumé en anglais
HIGM syndrome is a rare immunodeficiency characterized by high or normal levels of serum IgM associated with low levels of IgG, IgA and IgE. We selected 15 patients with clinical diagnosis suggestive of AR-HIGM, 10 females, 05 males, where 11 are Brazilian, one is French and three are Turkish, with ages ranging from 2 to 40 years. All patients had recurrent infections: 100% pneumonia, 80% acute otitis media, 53% sinusitis, 46% tonsillitis, 40% recurrent diarrhea, 26% urinary tract infections, 20% stomatitis, and one patient presented a cutaneous mycobacteriosis. 20% of the patients had opportunistic infections: Mycobacterium marinum, Toxoplasma gondii, varicella-zoster virus, Pseudomonas aeruginosa, fungus, and Mycobacterium tuberculosis. As a result, we found two types of mutations in 4 diferent patients with no consanguinity. We found in AICDA gene the following mutations: Patients EJ and GF missense mutation in base 260 in cDNA, which results in a change of aminoacid (c.260G> C; Cys87Ser p.). Patients DA and RC showed a splice defect, resulting in a complete deletion of exon 4 in AICDA gene. All other patients were sequenced for AICDA, UNG and CD40 genes, and no changes were found. In this case, we studied the INO80 gene, and we found in exons 04 (g.24012 G> A) and 26 (g.99976 G> T) INO80 gene, two heterozygous missense mutations in DNAg of patient OD. Since these molecular genetic defects result in similar clinical features, molecular and genetic studies are important for the differential diagnosis, therapeutic strategy and prognosis of the cases.
 
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Date de Publication
2012-03-14
 
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