Presentación de un paciente con agammaglobulinemia congénita / Report of a Patient with Congenital Agammaglobulinemia

La agammaglobulinemia congénita o enfermedad de Bruton es una inmunodeficiencia primaria que se hereda con carácter recesivo ligado al cromosoma X. Esta mutación impide la codificación por ese gen de una enzima tirosina quinasa citoplasmática, necesaria para la maduración de las células B. Esto impide la producción de inmunoglobulinas y el tratamiento sustitutivo con gamma endovenoso es fundamental. Esta afección se diagnosticó en un niño de seis meses que acudió a la institución de salud por infecciones no controladas y en estado muy grave. Se realizó cuantificación de inmunoglobulinas y se demostró su carencia, se indicó tratamiento con gammaglobulina endovenosa a dosis de 300 mg/kg de peso primero semanal y luego cada tres semanas. Se obtuvieron buenos resultados, se logró salvar la vida del paciente y se mantuvo estable, sin infecciones.

The congenital agammaglobulinemia or Bruton’s disease is a primary immunodeficiency that is inherited as an X-linked recessive. This mutation prevents the gene encoding a cytoplasmic tyrosine kinase enzyme necessary for the maturation of B cells. This prevents the production of immunoglobulin replacement therapy and intravenous gamma is important. This condition was diagnosed in a child of six months who came to the health institution with uncontrolled infections, in critical stage. Quantification of immunoglobulins was performed and it demonstrated its absence, indicating intravenous gammaglobulin treatment at doses of 300 mg / kg weekly first and then every three weeks. Good results were obtained, without complications.

Kennedy Disease Showing Prominent Remyelinating Features of Sural Nerve

We report a 55-year-old man with chronic weakness of both legs with recently experienced nasal voice. Despite the absence of sensory symptoms, electrophysiologic studies revealed the presence of sensorimotor polyneuropathy. A sural-nerve biopsy showed remarkable reduction of large myelinated fibers with prominent remyelination. Intravenous immunoglobulin was administered due to suspected chronic demyelinating neuropathy, but had no effect. Abnormal trinucleotide-repeat expansion of the androgen receptor gene was subsequently detected in both the patient and his family. These observation indicate that prominent remyelinating features are not necessarily indicative of demyelinating neuropathy.

A Case of X;Y Translocation with Complex Minor Anomalies and Mental Retardation: 46,Y,der(X)t(X;Y)(p22.3;q11.2)mat / 대한임상병리학회지

A three year old boy was admitted due to minor anomalies, such as hypertelorism, clinodactyly, ear anomaly, simian crease, renal anomalies, cryptorchism and mild mental retardation. The chro-mosome and FISH analysis showed 46,Y,der(X)t(X;Y)(p22.3;q11.2), and the same chromosomal pattern was found in the mother, who showed no phenotypic anomalies or mental retardation. According to previously reported X-Y translocation cases, the Xp22.3 was the most common breakpoint and many X-linked diseases, which are regulated by the genes located in Xp22.3, were expressed in a variable pattern, such as chondrodysplasia punctata, X-linked ichthyosis, mental retardation, Kallmann syndrome as the sole anomaly or a complex pattern. This boy did not show the typical anomalies that correspond to the above diseases. However, regular follow up and addi-tional studies with adequate counseling will be necessary due to the possibility of delayed ccurence of other typical symptoms and problems such as infertility as he grows up.