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    Mycobacterial disease in patients with chronic granulomatous disease: A retrospective analysis of 71 cases
    (Mosby Inc., 2016) Conti F.; Lugo-Reyes S.O.; Blancas Galicia L.; He J.; Aksu G.; Borges de Oliveira E.; Jr.; Deswarte C.; Hubeau M.; Karaca N.; de Suremain M.; Guérin A.; Baba L.A.; Prando C.; Guerrero G.G.; Emiroglu M.; Öz F.N.; Yamazaki Nakashimada M.A.; Gonzalez Serrano E.; Espinosa S.; Barlan I.; Pérez N.; Regairaz L.; Guidos Morales H.E.; Bezrodnik L.; Di Giovanni D.; Dbaibo G.; Ailal F.; Galicchio M.; Oleastro M.; Chemli J.; Danielian S.; Perez L.; Ortega M.C.; Soto Lavin S.; Hertecant J.; Anal O.; Kechout N.; Al-Idrissi E.; ElGhazali G.; Bondarenko A.; Chernyshova L.; Ciznar P.; Herbigneaux R.-M.; Diabate A.; Ndaga S.; Konte B.; Czarna A.; Migaud M.; Pedraza-Sánchez S.; Zaidi M.B.; Vogt G.; Blanche S.; Benmustapha I.; Mansouri D.; Abel L.; Boisson-Dupuis S.; Mahlaoui N.; Bousfiha A.A.; Picard C.; Barbouche R.; Al-Muhsen S.; Espinosa-Rosales F.J.; Kütükçüler N.; Condino-Neto A.; Casanova J.-L.; Bustamante J.
    Background Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by inborn errors of the phagocyte nicotinamide adenine dinucleotide phosphate oxidase complex. From the first year of life onward, most affected patients display multiple, severe, and recurrent infections caused by bacteria and fungi. Mycobacterial infections have also been reported in some patients. Objective Our objective was to assess the effect of mycobacterial disease in patients with CGD. Methods We analyzed retrospectively the clinical features of mycobacterial disease in 71 patients with CGD. Tuberculosis and BCG disease were diagnosed on the basis of microbiological, pathological, and/or clinical criteria. Results Thirty-one (44%) patients had tuberculosis, and 53 (75%) presented with adverse effects of BCG vaccination; 13 (18%) had both tuberculosis and BCG infections. None of these patients displayed clinical disease caused by environmental mycobacteria, Mycobacterium leprae, or Mycobacterium ulcerans. Most patients (76%) also had other pyogenic and fungal infections, but 24% presented solely with mycobacterial disease. Most patients presented a single localized episode of mycobacterial disease (37%), but recurrence (18%), disseminated disease (27%), and even death (18%) were also observed. One common feature in these patients was an early age at presentation for BCG disease. Mycobacterial disease was the first clinical manifestation of CGD in 60% of these patients. Conclusion Mycobacterial disease is relatively common in patients with CGD living in countries in which tuberculosis is endemic, BCG vaccine is mandatory, or both. Adverse reactions to BCG and severe forms of tuberculosis should lead to a suspicion of CGD. BCG vaccine is contraindicated in patients with CGD. © 2016 American Academy of Allergy, Asthma & Immunology
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    Revisiting human IL-12Rß1 deficiency: A survey of 141 patients from 30 countries
    (2010) De Beaucoudrey L.; Samarina A.; Bustamante J.; Cobat A.; Boisson-Dupuis S.; Feinberg J.; Al-Muhsen S.; Jannière L.; Rose Y.; De Suremain M.; Kong X.-F.; Filipe-Santos O.; Chapgier A.; Picard C.; Fischer A.; Dogu F.; Ikinciogullari A.; Tanir G.; Al-Hajjar S.; Al-Jumaah S.; Frayha H.H.; Alsum Z.; Al-Ajaji S.; Alangari A.; Al-Ghonaium A.; Adimi P.; Mansouri D.; Ben-Mustapha I.; Yancoski J.; Garty B.-Z.; Rodriguez-Gallego C.; Caragol I.; Kutukculer N.; Kumararatne D.S.; Patel S.; Doffinger R.; Exley A.; Jeppsson O.; Reichenbach J.; Nadal D.; Boyko Y.; Pietrucha B.; Anderson S.; Levin M.; Schandené L.; Schepers K.; Efira A.; Mascart F.; Matsuoka M.; Sakai T.; Siegrist C.-A.; Frecerova K.; Blüetters-Sawatzki R.; Bernhöft J.; Freihorst J.; Baumann U.; Richter D.; Haerynck F.; De Baets F.; Novelli V.; Lammas D.; Vermylen C.; Tuerlinckx D.; Nieuwhof C.; Pac M.; Haas W.H.; Müller-Fleckenstein I.; Fleckenstein B.; Levy J.; Raj R.; Cohen A.C.; Lewis D.B.; Holland S.M.; Yang K.D.; Wang X.; Wang X.; Jiang L.; Yang X.; Zhu C.; Xie Y.; Lee P.P.W.; Chan K.W.; Chen T.-X.; Castro G.; Natera I.; Codoceo A.; King A.; Bezrodnik L.; Di Giovani D.; Gaillard M.I.; De Moraes-Vasconcelos D.; Grumach A.S.; Da Silva Duarte A.J.; Aldana R.; Espinosa-Rosales F.J.; Bejaoui M.; Bousfiha A.A.; Baghdadi J.E.; Özbek N.; Aksu G.; Keser M.; Somer A.; Hatipoglu N.; Aydogmus C.; Asilsoy S.; Camcioglu Y.; Gülle S.; Ozgur T.T.; Ozen M.; Oleastro M.; Bernasconi A.; Mamishi S.; Parvaneh N.; Rosenzweig S.; Barbouche R.; Pedraza S.; Lau Y.L.; Ehlayel M.S.; Fieschi C.; Abel L.; Sanal O.; Casanova J.-L.
    Interleukin-12 receptor ß1 (IL-12Rß1) deficiency is the most common form of Mendelian susceptibility to mycobacterial disease (MSMD). We undertook an international survey of 141 patients from 102 kindreds in 30 countries. Among 102 probands, the first infection occurred at a mean age of 2.4 years. In 78 patients, this infection was caused by Bacille Calmette-Guérin (BCG; n = 65), environmental mycobacteria (EM; also known as atypical or nontuberculous mycobacteria) (n = 9) or Mycobacterium tuberculosis (n = 4). Twenty-two of the remaining 24 probands initially presented with nontyphoidal, extraintestinal salmonellosis. Twenty of the 29 genetically affected sibs displayed clinical signs (69%); however 8 remained asymptomatic (27%). Nine nongenotyped sibs with symptoms died. Recurrent BCG infection was diagnosed in 15 cases, recurrent EM in 3 cases, recurrent salmonellosis in 22 patients. Ninety of the 132 symptomatic patients had infections with a single microorganism. Multiple infections were diagnosed in 40 cases, with combined mycobacteriosis and salmonellosis in 36 individuals. BCG disease strongly protected against subsequent EM disease (p = 0.00008). Various other infectious diseases occurred, albeit each rarely, yet candidiasis was reported in 33 of the patients (23%). Ninety-nine patients (70%) survived, with a mean age at last follow-up visit of 12.7 years ± 9.8 years (range, 0.5-46.4 yr). IL-12Rß1 deficiency is characterized by childhood-onset mycobacteriosis and salmonellosis, rare recurrences of mycobacterial disease, and more frequent recurrence of salmonellosis. The condition has higher clinical penetrance, broader susceptibility to infections, and less favorable outcome than previously thought. © 2010 Lippincott Williams & Wilkins.