Analysis of clinical and molecular genetic characteristics of Wiskott-Aldrich syndrome and X-linked thrombocytopenia

Introduction. Wiskott-Aldrich syndrome is a rare X-linked disorder characterized by microthrombocytopenia, eczema, and recurrent infections. It is caused by mutations of the WAS gene which encodes the WAS protein (WASp) – a key regulator of actin polymerization in hematopoietic cells. Mutations within the WASp gene result in a wide heterogeneity of clinical disease, ranging from ‘classical WAS’ to mild asymptomatic thrombocytopenia (X-linked thrombocytopenia [XLT]), or congenital neutropenia (X-lined neutropenia [XLN]).Case presentation. This present paper reports a phenotypical and laboratory description of two children diagnosed with WAS and one child diagnosed with XLT. The first case was a six months old male with septicemia, thrombocytopenia, eczema and petechial rash. The second case was a 2 years old boy presenting with complaints of recurrent infections, eczema and thrombocytopenia with small platelet size. The third case was a 16 years old boy who presented with thrombocytopenia and recurrent sinopulmonary infections.Conclusions. Due to a wide spectrum of clinical findings, the diagnosis of WAS/XLT should be considered in any male patient presenting with petechiae, bruises, and congenital or early-onset thrombocytopenia associated with small platelet size.

[1]  A. Worth,et al.  How I manage patients with Wiskott Aldrich syndrome , 2019, British journal of haematology.

[2]  F. Bushman,et al.  Gene therapy for Wiskott-Aldrich syndrome in a severely affected adult. , 2017, Blood.

[3]  X. Tian,et al.  Whole Wiskott-Aldrich syndrome protein gene deletion identified by high throughput sequencing , 2017, Molecular medicine reports.

[4]  I. Adcock,et al.  Cancers Related to Immunodeficiencies: Update and Perspectives , 2016, Front. Immunol..

[5]  David A. Williams,et al.  Gene Therapy Using a Self-Inactivating Lentiviral Vector Improves Clinical and Laboratory Manifestations of Wiskott-Aldrich Syndrome , 2015 .

[6]  A. Worth,et al.  Current and emerging treatment options for Wiskott–Aldrich syndrome , 2015, Expert review of clinical immunology.

[7]  Frederic D Bushman,et al.  Outcomes following gene therapy in patients with severe Wiskott-Aldrich syndrome. , 2015, JAMA.

[8]  D. Buchbinder,et al.  Wiskott–Aldrich syndrome: diagnosis, current management, and emerging treatments , 2014, The application of clinical genetics.

[9]  Michael Rothe,et al.  Gene Therapy for Wiskott-Aldrich Syndrome—Long-Term Efficacy and Genotoxicity , 2014, Science Translational Medicine.

[10]  R. Geha,et al.  Wiskott‐Aldrich syndrome: a comprehensive review , 2013, Annals of the New York Academy of Sciences.

[11]  T. Morio,et al.  Wiskott–Aldrich syndrome presenting with a clinical picture mimicking juvenile myelomonocytic leukaemia , 2013, Pediatric blood & cancer.

[12]  Yi Zheng,et al.  Cdc42 regulates neutrophil migration via crosstalk between WASp, CD11b, and microtubules. , 2012, Blood.

[13]  M. C. Castiello,et al.  Autoimmunity in Wiskott–Aldrich Syndrome: An Unsolved Enigma , 2012, Front. Immun..

[14]  N. Weidner,et al.  Hodgkin's and Non-Hodgkin's Lymphomas Occurring in Two Brothers with Wiskott-Aldrich Syndrome and Review of the Literature , 2011, Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society.

[15]  D. Song,et al.  A Familial Case of Wiskott-Aldrich Syndrome with a Hotspot Mutation in Exon 2 of the WAS Gene , 2007, Journal of Korean medical science.

[16]  C. Klein,et al.  Development of hematopoietic stem cell gene therapy for Wiskott-Aldrich syndrome. , 2006, Current opinion in molecular therapeutics.

[17]  E. Remold-O’Donnell,et al.  A novel protocol to identify mutations in patients with wiskott-Aldrich syndrome. , 2002, Blood cells, molecules & diseases.