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Pulmonary alveolar proteinosis with hypogammaglobulinemia(PAPHG; IMD100)

MedGen UID:
1648298
Concept ID:
C4747984
Disease or Syndrome
Synonyms: IMD100; IMMUNODEFICIENCY 100 WITH PULMONARY ALVEOLAR PROTEINOSIS AND HYPOGAMMAGLOBULINEMIA; PAPHG; PULMONARY ALVEOLAR PROTEINOSIS WITH HYPOGAMMAGLOBULINEMIA
 
Gene (location): OAS1 (12q24.13)
 
Monarch Initiative: MONDO:0020840
OMIM®: 618042

Definition

Immunodeficiency-100 with pulmonary alveolar proteinosis and hypogammaglobulinemia (IMD100) is primarily a lung disorder characterized by onset of respiratory insufficiency due to pulmonary alveolar proteinosis (PAP) in the first months of life. Affected individuals may have normal respiratory function at birth. Development of the disorder appears to be influenced or triggered by viral infection, manifest as progressive respiratory insufficiency, confluent consolidations on lung imaging, and diffuse collection of periodic acid-Schiff (PAS)-positive material in pulmonary alveoli associated with small and nonfoamy alveolar macrophages. Patients also have hypogammaglobulinemia, leukocytosis, and splenomegaly. Many patients die of respiratory failure in infancy or early childhood; hematopoietic stem cell transplantation (HSCT) is curative. The pathogenesis may be related to abnormal function of alveolar macrophages, resulting in decreased catabolism of surfactant (summary by Cho et al., 2018). Magg et al. (2021) determined that the disorder results from a gain-of-function effect that particularly affects B cells and monocytes. [from OMIM]

Clinical features

From HPO
Respiratory insufficiency
MedGen UID:
11197
Concept ID:
C0035229
Pathologic Function
Impairment of gas exchange within the lungs secondary to a disease process, neoplasm, or trauma, possibly resulting in hypoxia, hypercarbia, or both, but not requiring intubation or mechanical ventilation. Patients are normally managed with pharmaceutical therapy, supplemental oxygen, or both.
Recurrent respiratory infections
MedGen UID:
812812
Concept ID:
C3806482
Finding
An increased susceptibility to respiratory infections as manifested by a history of recurrent respiratory infections.
Pulmonary alveolar proteinosis
MedGen UID:
1763046
Concept ID:
C5400698
Finding
Accumulation of amorphous PAS-positive material in the space between alveolar macrophages, sometimes as condensed form (oval bodies) are typically found in alveolar proteinosis.
Leukocytosis
MedGen UID:
9736
Concept ID:
C0023518
Disease or Syndrome
An abnormal increase in the number of leukocytes in the blood.
Splenomegaly
MedGen UID:
52469
Concept ID:
C0038002
Finding
Abnormal increased size of the spleen.
Decreased circulating antibody concentration
MedGen UID:
892481
Concept ID:
C4048270
Finding
An abnormally decreased level of immunoglobulin in blood.

Recent clinical studies

Etiology

Grunebaum E, Cutz E, Roifman CM
J Allergy Clin Immunol 2012 Jun;129(6):1588-93. Epub 2012 Mar 10 doi: 10.1016/j.jaci.2012.02.003. PMID: 22409989

Diagnosis

Seidl E, Schramm D, Schön C, Reiter K, Pawlita I, Kappler M, Reu-Hofer S, Hauck F, Albert M, Griese M
Pediatr Pulmonol 2022 Jan;57(1):273-277. Epub 2021 Nov 15 doi: 10.1002/ppul.25728. PMID: 34647697
Magg T, Okano T, Koenig LM, Boehmer DFR, Schwartz SL, Inoue K, Heimall J, Licciardi F, Ley-Zaporozhan J, Ferdman RM, Caballero-Oteyza A, Park EN, Calderon BM, Dey D, Kanegane H, Cho K, Montin D, Reiter K, Griese M, Albert MH, Rohlfs M, Gray P, Walz C, Conn GL, Sullivan KE, Klein C, Morio T, Hauck F
Sci Immunol 2021 Jun 18;6(60) doi: 10.1126/sciimmunol.abf9564. PMID: 34145065Free PMC Article
Flinn AM, Gennery AR
Orphanet J Rare Dis 2018 Apr 24;13(1):65. doi: 10.1186/s13023-018-0807-5. PMID: 29690908Free PMC Article
Grunebaum E, Cohen A, Roifman CM
Curr Opin Allergy Clin Immunol 2013 Dec;13(6):630-8. doi: 10.1097/ACI.0000000000000006. PMID: 24113229
Grunebaum E, Cutz E, Roifman CM
J Allergy Clin Immunol 2012 Jun;129(6):1588-93. Epub 2012 Mar 10 doi: 10.1016/j.jaci.2012.02.003. PMID: 22409989

Therapy

Grunebaum E, Cohen A, Roifman CM
Curr Opin Allergy Clin Immunol 2013 Dec;13(6):630-8. doi: 10.1097/ACI.0000000000000006. PMID: 24113229
Grunebaum E, Cutz E, Roifman CM
J Allergy Clin Immunol 2012 Jun;129(6):1588-93. Epub 2012 Mar 10 doi: 10.1016/j.jaci.2012.02.003. PMID: 22409989
Cho K, Nakata K, Ariga T, Okajima S, Matsuda T, Ueda K, Furuta I, Kobayashi K, Minakami H
Respirology 2006 Jan;11 Suppl:S74-7. doi: 10.1111/j.1440-1843.2006.00814.x. PMID: 16423278

Prognosis

Seidl E, Schramm D, Schön C, Reiter K, Pawlita I, Kappler M, Reu-Hofer S, Hauck F, Albert M, Griese M
Pediatr Pulmonol 2022 Jan;57(1):273-277. Epub 2021 Nov 15 doi: 10.1002/ppul.25728. PMID: 34647697

Clinical prediction guides

Cho K, Yamada M, Agematsu K, Kanegane H, Miyake N, Ueki M, Akimoto T, Kobayashi N, Ikemoto S, Tanino M, Fujita A, Hayasaka I, Miyamoto S, Tanaka-Kubota M, Nakata K, Shiina M, Ogata K, Minakami H, Matsumoto N, Ariga T
Am J Hum Genet 2018 Mar 1;102(3):480-486. Epub 2018 Feb 15 doi: 10.1016/j.ajhg.2018.01.019. PMID: 29455859Free PMC Article
Grunebaum E, Cohen A, Roifman CM
Curr Opin Allergy Clin Immunol 2013 Dec;13(6):630-8. doi: 10.1097/ACI.0000000000000006. PMID: 24113229

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