U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Immunodeficiency 117(IMD117)

MedGen UID:
1848763
Concept ID:
C5882739
Disease or Syndrome
Synonyms: IMD117; IMMUNODEFICIENCY 117, MYCOBACTERIOSIS, AUTOSOMAL RECESSIVE
 
Gene (location): IRF1 (5q31.1)
 
Monarch Initiative: MONDO:0958011
OMIM®: 620668

Definition

Immunodeficiency-117 (IMD117) is an autosomal recessive immunologic disorder characterized by increased susceptibility to disseminated mycobacterial infection apparent in early childhood. Affected individuals develop mycobacterial disease after BCG (bacille Calmette-Guerin) vaccination and show increased susceptibility to other mycobacterial infections, such as M. avium. Immunologic workup shows impaired development of myeloid and lymphoid cell subsets that secrete and respond to gamma-interferon (IFNG; 147570) (et al., 2023). [from OMIM]

Clinical features

From HPO
Clubbing
MedGen UID:
57692
Concept ID:
C0149651
Anatomical Abnormality
Broadening of the soft tissues (non-edematous swelling of soft tissues) of the digital tips in all dimensions associated with an increased longitudinal and lateral curvature of the nails.
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Diarrhea
MedGen UID:
8360
Concept ID:
C0011991
Sign or Symptom
Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.
Hepatomegaly
MedGen UID:
42428
Concept ID:
C0019209
Finding
Abnormally increased size of the liver.
Intestinal malrotation
MedGen UID:
113153
Concept ID:
C0221210
Congenital Abnormality
An abnormality of the intestinal rotation and fixation that normally occurs during the development of the gut. This can lead to volvulus, or twisting of the intestine that causes obstruction and necrosis.
Anemia
MedGen UID:
1526
Concept ID:
C0002871
Disease or Syndrome
A reduction in erythrocytes volume or hemoglobin concentration.
Thrombocytopenia
MedGen UID:
52737
Concept ID:
C0040034
Disease or Syndrome
A reduction in the number of circulating thrombocytes.
Recurrent lower respiratory tract infections
MedGen UID:
756211
Concept ID:
C3163798
Disease or Syndrome
An increased susceptibility to lower respiratory tract infections as manifested by a history of recurrent lower respiratory tract infections.
Histoplasmosis
MedGen UID:
42468
Concept ID:
C0019655
Disease or Syndrome
Histoplasmosis is caused by the fungus Histoplasma capsulatum and is consider to be an opportunistic infection in immunosuppressed persons.
Leukopenia
MedGen UID:
6073
Concept ID:
C0023530
Disease or Syndrome
An abnormal decreased number of leukocytes in the blood.
Lymphadenitis
MedGen UID:
7410
Concept ID:
C0024205
Disease or Syndrome
Inflammation of a lymph node.
Pneumonia
MedGen UID:
10813
Concept ID:
C0032285
Disease or Syndrome
Inflammation of any part of the lung parenchyma.
Sinusitis
MedGen UID:
20772
Concept ID:
C0037199
Disease or Syndrome
Inflammation of the paranasal sinuses owing to a viral, bacterial, or fungal infection, allergy, or an autoimmune reaction.
Splenomegaly
MedGen UID:
52469
Concept ID:
C0038002
Finding
Abnormal increased size of the spleen.
Pustular rash
MedGen UID:
43222
Concept ID:
C0085641
Sign or Symptom
A rash composed of pustular lesions. A pustule is defined as a vesicle or bulla containing purulent material. It varies in size and may occur at different levels within the epidermis
Increased circulating IgA concentration
MedGen UID:
66800
Concept ID:
C0239984
Finding
An abnormally increased level of immunoglobulin A in blood.
Axillary lymphadenopathy
MedGen UID:
107913
Concept ID:
C0578735
Pathologic Function
Enlarged lymph node located in the axillary region (armpit).
Reduced natural killer cell count
MedGen UID:
383765
Concept ID:
C1855767
Finding
Less than normal number of natural killer cells, a type of lymphocyte in the innate immune system with an ability to mediate cytotoxicity and produce cytokines after the ligation of a germline-encoded activation receptor.
T lymphocytopenia
MedGen UID:
419385
Concept ID:
C2931322
Finding
An abnormally low count of T cells.
BCGosis
MedGen UID:
823215
Concept ID:
C3830467
Disease or Syndrome
Distant, or disseminated infection with Bacillus Calmette-Guerin (BCG) following vaccination associated with failure to contain thebacillus Calmette-Guerin (BCG) following vaccination leading to spread of BCG to many sites in the body. The tuberculosis vaccine BCG contains live attenuated Mycobacterium bovis.
Recurrent mycobacterial infections
MedGen UID:
869021
Concept ID:
C4023438
Finding
Increased susceptibility to mycobacterial infections, as manifested by recurrent episodes of mycobacterial infection.
Increased proportion of transitional B cells
MedGen UID:
892766
Concept ID:
C4072920
Finding
An elevation in the normal proportion of transitional B cells (CD19+/CD38high/IgMhigh) in circulation relative to the total number of B cells. B cells originate from precursors in the bone marrow, and the first cells which migrate to the peripheral blood have been classified as transitional B cells.
BCGitis
MedGen UID:
1684722
Concept ID:
C5139070
Disease or Syndrome
Local or regional infection with Bacillus Calmette-Guerin (BCG) following vaccination.
Nontuberculous mycobacterial pulmonary infection
MedGen UID:
1700174
Concept ID:
C5139228
Disease or Syndrome
An infection of the lung caused by environmental mycobacteria. Such infections can occur in individuals with predisposing lung disease or immune disease.
Disseminated nontuberculous mycobacterial infection
MedGen UID:
1687715
Concept ID:
C5139240
Disease or Syndrome
An infection with nontuberculous mycobacteria that affects multiple body sites. Such infections can occur in individuals with immune disease.
Decreased proportion of naive CD8 T cells
MedGen UID:
1694295
Concept ID:
C5139538
Finding
An abnormally reduced proportion of naive CD8 T cells relative to the total number of T cells.
Decreased proportion of central memory CD8-positive, alpha-beta T cells
MedGen UID:
1686898
Concept ID:
C5139550
Finding
A reduced proportion of CD8-positive, alpha-beta central memory T cells compared to the total number of T cells in the blood. These cells have the phenotype CCR7-negative, CD127-positive, CD45RA-negative, CD45RO-positive, and CD25-negative.
Increased proportion of effector memory CD8-positive, alpha-beta T cells
MedGen UID:
1690695
Concept ID:
C5139556
Finding
An increased proportion of effector memory CD8-positive, alpha-beta T cells compared to the total number of T cells in the blood. These cells have the phenotype CCR7-negative, CD127-positive, CD45RA-negative, CD45RO-positive, and CD25-negative.
Increased proportion of CD8-positive, alpha-beta TEMRA T cells
MedGen UID:
1717191
Concept ID:
C5398015
Finding
An increased proportion of CD8-positive, alpha-beta effector memory RA TEMRA T cells compared to the total number of T cells in the blood. These cells have the phenotype CD45RA-positive, CD45RO-negative, and CCR7-negative.
Fever
MedGen UID:
5169
Concept ID:
C0015967
Sign or Symptom
Body temperature elevated above the normal range.
Positive Mycobacterium avium sputum culture
MedGen UID:
1054801
Concept ID:
CN377051
Finding
Growth of mycobacterium avium in a sputum culture.
Mediastinal lymphadenopathy
MedGen UID:
451062
Concept ID:
C0520743
Disease or Syndrome
Swelling of lymph nodes within the mediastinum, the central compartment of the thoracic cavities that contains the heart and the great vessels, the esophagus, and trachea and other structures including lymph nodes.
Cafe-au-lait spot
MedGen UID:
113157
Concept ID:
C0221263
Finding
Cafe-au-lait spots are hyperpigmented lesions that can vary in color from light brown to dark brown with smooth borders and having a size of 1.5 cm or more in adults and 0.5 cm or more in children.

Professional guidelines

PubMed

Del Romero J, García-Pérez JN, Espasa-Soley M
Enferm Infecc Microbiol Clin (Engl Ed) 2019 Feb;37(2):117-126. Epub 2018 Dec 24 doi: 10.1016/j.eimc.2018.11.008. PMID: 30591390
Chiarella SE, Grammer LC
Expert Rev Clin Immunol 2017 Feb;13(2):117-123. Epub 2016 Aug 18 doi: 10.1080/1744666X.2016.1216790. PMID: 27500811Free PMC Article
Harris DG
Br Med Bull 2014 Jun;110(1):117-28. Epub 2014 May 7 doi: 10.1093/bmb/ldu010. PMID: 24810848

Recent clinical studies

Etiology

Mitjà O, Alemany A, Marks M, Lezama Mora JI, Rodríguez-Aldama JC, Torres Silva MS, Corral Herrera EA, Crabtree-Ramirez B, Blanco JL, Girometti N, Mazzotta V, Hazra A, Silva M, Montenegro-Idrogo JJ, Gebo K, Ghosn J, Peña Vázquez MF, Matos Prado E, Unigwe U, Villar-García J, Wald-Dickler N, Zucker J, Paredes R, Calmy A, Waters L, Galvan-Casas C, Walmsley S, Orkin CM; SHARE-NET writing group
Lancet 2023 Mar 18;401(10380):939-949. Epub 2023 Feb 21 doi: 10.1016/S0140-6736(23)00273-8. PMID: 36828001
van Wyngaard A, Whiteside A
Afr J AIDS Res 2021 Jul;20(2):117-124. doi: 10.2989/16085906.2021.1948877. PMID: 34264162
Szczawinska-Poplonyk A, Begier K, Dorota A, Dabrowska M, Galecka D, Wawrzeniak K, Wroblewski K
Allergol Immunopathol (Madr) 2021;49(4):117-136. Epub 2021 Jul 1 doi: 10.15586/aei.v49i4.200. PMID: 34224226
Marra CM
Handb Clin Neurol 2018;152:117-122. doi: 10.1016/B978-0-444-63849-6.00009-8. PMID: 29604970
Notarangelo LD, Lanzi G, Peron S, Durandy A
J Allergy Clin Immunol 2006 Apr;117(4):855-64. doi: 10.1016/j.jaci.2006.01.043. PMID: 16630945

Diagnosis

Mitjà O, Alemany A, Marks M, Lezama Mora JI, Rodríguez-Aldama JC, Torres Silva MS, Corral Herrera EA, Crabtree-Ramirez B, Blanco JL, Girometti N, Mazzotta V, Hazra A, Silva M, Montenegro-Idrogo JJ, Gebo K, Ghosn J, Peña Vázquez MF, Matos Prado E, Unigwe U, Villar-García J, Wald-Dickler N, Zucker J, Paredes R, Calmy A, Waters L, Galvan-Casas C, Walmsley S, Orkin CM; SHARE-NET writing group
Lancet 2023 Mar 18;401(10380):939-949. Epub 2023 Feb 21 doi: 10.1016/S0140-6736(23)00273-8. PMID: 36828001
Dian S, Ganiem AR, Ekawardhani S
Pathog Glob Health 2023 Feb;117(1):14-23. Epub 2022 Jun 11 doi: 10.1080/20477724.2022.2083977. PMID: 35694771Free PMC Article
Tarín-Vicente EJ, Alemany A, Agud-Dios M, Ubals M, Suñer C, Antón A, Arando M, Arroyo-Andrés J, Calderón-Lozano L, Casañ C, Cabrera JM, Coll P, Descalzo V, Folgueira MD, García-Pérez JN, Gil-Cruz E, González-Rodríguez B, Gutiérrez-Collar C, Hernández-Rodríguez Á, López-Roa P, de Los Ángeles Meléndez M, Montero-Menárguez J, Muñoz-Gallego I, Palencia-Pérez SI, Paredes R, Pérez-Rivilla A, Piñana M, Prat N, Ramirez A, Rivero Á, Rubio-Muñiz CA, Vall M, Acosta-Velásquez KS, Wang A, Galván-Casas C, Marks M, Ortiz-Romero PL, Mitjà O
Lancet 2022 Aug 27;400(10353):661-669. Epub 2022 Aug 8 doi: 10.1016/S0140-6736(22)01436-2. PMID: 35952705Free PMC Article
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Rahimian P, He JJ
Prog Neurobiol 2017 Oct;157:117-132. Epub 2016 Apr 12 doi: 10.1016/j.pneurobio.2016.04.003. PMID: 27084354Free PMC Article

Therapy

Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Marra CM
Handb Clin Neurol 2018;152:117-122. doi: 10.1016/B978-0-444-63849-6.00009-8. PMID: 29604970
Andrews B, Semler MW, Muchemwa L, Kelly P, Lakhi S, Heimburger DC, Mabula C, Bwalya M, Bernard GR
JAMA 2017 Oct 3;318(13):1233-1240. doi: 10.1001/jama.2017.10913. PMID: 28973227Free PMC Article
Chiarella SE, Grammer LC
Expert Rev Clin Immunol 2017 Feb;13(2):117-123. Epub 2016 Aug 18 doi: 10.1080/1744666X.2016.1216790. PMID: 27500811Free PMC Article
Babayev R, Terner S, Chandra S, Radhakrishnan J, Mohan S
Am J Kidney Dis 2013 Dec;62(6):1188-92. Epub 2013 Jul 26 doi: 10.1053/j.ajkd.2013.06.007. PMID: 23891358

Prognosis

Schmidt A, Groh AM, Frick JS, Vehreschild MJGT, Ludwig KU
Dtsch Arztebl Int 2022 Feb 25;119(8):117-123. doi: 10.3238/arztebl.m2022.0105. PMID: 35101171Free PMC Article
Dutta Majumder P, Chen EJ, Shah J, Ching Wen Ho D, Biswas J, See Yin L, Gupta V, Pavesio C, Agrawal R
Ocul Immunol Inflamm 2019;27(1):117-125. Epub 2017 Oct 11 doi: 10.1080/09273948.2017.1371765. PMID: 29020491
Andrews B, Semler MW, Muchemwa L, Kelly P, Lakhi S, Heimburger DC, Mabula C, Bwalya M, Bernard GR
JAMA 2017 Oct 3;318(13):1233-1240. doi: 10.1001/jama.2017.10913. PMID: 28973227Free PMC Article
Mitsuyasu RT
Top HIV Med 2008 Oct-Nov;16(4):117-21. PMID: 18838745
Leichman LP, Cummings BJ
Curr Probl Cancer 1990 May-Jun;14(3):117-59. doi: 10.1016/0147-0272(90)90014-h. PMID: 2202554

Clinical prediction guides

Corona D, Pérez-Valero I, Camacho A, Gutiérrez Liarte Á, Montero-Alonso M, Alemán MR, Ruiz-Seco P, Pérez González A, Riera M, Jarrin I, Rivero-Juárez A, Rivero A
Int J Antimicrob Agents 2024 Jan;63(1):107016. Epub 2023 Oct 26 doi: 10.1016/j.ijantimicag.2023.107016. PMID: 37890734
Gandhi M, Hickey M, Imbert E, Grochowski J, Mayorga-Munoz F, Szumowski JD, Oskarsson J, Shiels M, Sauceda J, Salazar J, Dilworth S, Nguyen JQ, Glidden DV, Havlir DV, Christopoulos KA
Ann Intern Med 2023 Jul;176(7):969-974. Epub 2023 Jul 4 doi: 10.7326/M23-0788. PMID: 37399555Free PMC Article
Tarín-Vicente EJ, Alemany A, Agud-Dios M, Ubals M, Suñer C, Antón A, Arando M, Arroyo-Andrés J, Calderón-Lozano L, Casañ C, Cabrera JM, Coll P, Descalzo V, Folgueira MD, García-Pérez JN, Gil-Cruz E, González-Rodríguez B, Gutiérrez-Collar C, Hernández-Rodríguez Á, López-Roa P, de Los Ángeles Meléndez M, Montero-Menárguez J, Muñoz-Gallego I, Palencia-Pérez SI, Paredes R, Pérez-Rivilla A, Piñana M, Prat N, Ramirez A, Rivero Á, Rubio-Muñiz CA, Vall M, Acosta-Velásquez KS, Wang A, Galván-Casas C, Marks M, Ortiz-Romero PL, Mitjà O
Lancet 2022 Aug 27;400(10353):661-669. Epub 2022 Aug 8 doi: 10.1016/S0140-6736(22)01436-2. PMID: 35952705Free PMC Article
Schmidt A, Groh AM, Frick JS, Vehreschild MJGT, Ludwig KU
Dtsch Arztebl Int 2022 Feb 25;119(8):117-123. doi: 10.3238/arztebl.m2022.0105. PMID: 35101171Free PMC Article
Mikhail N
Curr Hypertens Rep 2003 Apr;5(2):117-21. doi: 10.1007/s11906-003-0067-0. PMID: 12642010

Recent systematic reviews

Maccora I, Maniscalco V, Campani S, Carrera S, Abbati G, Marrani E, Mastrolia MV, Simonini G
Orphanet J Rare Dis 2023 May 13;18(1):117. doi: 10.1186/s13023-023-02721-6. PMID: 37179309Free PMC Article
Bagherzadeh-Fard M, Amin Yazdanifar M, Sadeghalvad M, Rezaei N
Int Immunopharmacol 2023 Apr;117:109366. Epub 2023 Mar 9 doi: 10.1016/j.intimp.2022.109366. PMID: 37012858
Laermans J, O D, Van den Bosch E, De Buck E, Compernolle V, Shinar E, Vandekerckhove P
Vox Sang 2022 Jun;117(6):769-779. Epub 2022 Feb 15 doi: 10.1111/vox.13255. PMID: 35167126Free PMC Article
Gutierrez J, Albuquerque ALA, Falzon L
PLoS One 2017;12(5):e0176686. Epub 2017 May 11 doi: 10.1371/journal.pone.0176686. PMID: 28493892Free PMC Article
Simoni JM, Nelson KM, Franks JC, Yard SS, Lehavot K
AIDS Behav 2011 Nov;15(8):1589-95. doi: 10.1007/s10461-011-9963-5. PMID: 21598034Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...