Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):470-473 | DOI: 10.5507/bp.2013.011

X-linked agammaglobulinemia caused by new mutation in BTK gene: A case report

Zuzana Havlicekova^a, Milos Jesenak^a, Tomas Freiberger^b, Peter Banovcin^a

^a Department of Paediatrics, Centre for diagnosis and treatment of primary immunodeficiencies, Jessenius Faculty of Medicine, Commenius University in Bratislava, Martin, Slovakia

^b Centre of cardiovascular and transplantation surgery, Brno, Czech Republic

Aim: Primary immunodeficiencies (PID) are becoming a recognized public health problem worldwide. The most important subgroup of these disorders are the antibody deficiencies. X-linked agammaglobulinaemia was the first described entity of this group and is characterised by early onset of recurrent bacterial infections, profound deficiency of all immunoglobulin isotypes and markedly reduced number of peripheral B-lymphocytes.

Case report: We report the case of a 10-year old boy with X-linked agammaglobulinaemia caused by a previously non-described mutation in BTK gene with typical clinical presentation but delayed diagnosis. Following diagnosis, substitution therapy with intravenous immunoglobulins was started and the clinical status of the patient improved.

Conclusion: We reported a case of X-linked agammaglobulinaemia with delayed diagnosis despite the typical anamnestic signs for primary humoral immunodeficiency. The disease was caused by a previously non-reported mutation in the BTK gene. Measurement of serum immunoglobulins should be performed in all children with recurrent, complicated respiratory infections as a screening test for humoral immunodeficiencies.

Keywords: awareness, B-lymphocytes, Bruton's tyrosine kinase, immunoglobulins, infectious complications, primary immunodeficiency, X-linked agammaglobulinemia

Received: June 15, 2012; Accepted: February 8, 2013; Prepublished online: March 22, 2013; Published: September 30, 2014  Show citation