Clinical Research and Practice
A case report of BCL11B mutation induced neurodevelopmental disorder and literature review
Yan Shi, Wei Yusi, Yang Qiuyun, Yang Lu, Zeng Ting, Tang Xuemei, Zhao Xiaodong, An Yunfei
Published 2020-03-02
Cite as Chin J Pediatr, 2020, 58(3): 223-227. DOI: 10.3760/cma.j.issn.0578-1310.2020.03.012
Abstract
ObjectiveTo analyze the clinical , immunological and genetic features of a child with BCL11B mutation induced neurodevelopmental disorder.
MethodsThe clinical data and genetic test of a child with BCL11B mutation hospitalized in the Department of Rheumatology and Immunology in Children′s Hospital of Chongqing Medical University in December 2018 were extracted and analyzed. The literature was searched with "BCL11B mutation" and "immunodeficiency 49" as key words in Chinese databases and Pubmed until January 2019 was reviewed.
ResultsA male patient aged 3 years and 11 months with facial dysmorphisms and delayed language and motor development was admitted due to neurodevelopmental retardation over two years. Laboratory tests showed normal human immunoglobulin (IgG 12.90 g/L, IgA 1.02 g/L, IgM 1.15 g/L, IgE 532 000 U/L), Trec (228) and proliferation of T and B cells. The lymphocyte subsets revealeda reduced percentage of B cells (0.108) but normal absolute numbers (0.574×10-3/L), and an increased percentage (0.828) as well as absolute numbers (4.415×10-3/L) of T cells. A heterozygous BCL11B mutation was detected by sanger sequencing, showing a de novo frameshift mutation c.1887_c.1893delCGGCGGG in exon 4. Two papers were found which were all in English, with total of 14 patients(13 patients with complete information). Thirteen mutations were reposed, including 7 frameshift, 2 nonsense, 2 missense, and 2 chromosomal rearrangements; Thirteen patients had heterozygous mutations. All patients had delayed language and motor development and facial dysplasia which were mainly hypertelorism, thin eyebrows and small palpebral fissures. Some patients had dental anomalies, ametropia and allergy, and a few were combined with immune impairment, but without overt signs of immunodeficiency. Only one patient had multisystem anomalies and profound immune deficiency.
ConclusionsBCL11B is essential for development of the nervous and the immune system. In this study, the de novo mutation of BCL11B gene resulted in neurodevelopmental and immunological disorders.
Key words:
Genes; Nervous system; Mutation
Contributor Information
Yan Shi
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Wei Yusi
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Yang Qiuyun
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Yang Lu
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Zeng Ting
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Tang Xuemei
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Zhao Xiaodong
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
An Yunfei
Department of Rheumatology and Immunology, Children′s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
