Table 1.
Summary of major clinical and laboratory findings
Patient 1, malePatient 2, malePatient 3, female
Age at presentation 5 mo 6 mo 10 mo 
Infection Recurrent pneumonia, EBV/CMV viremia, CMV pneumonia Congenital toxoplasmosis, recurrent pneumonia, varicella infection, CMV viremia, Candida pneumonia adenovirus + CMV PCR positive in BAL Recurrent pneumonia, urinary infections, gastroenteritis, CMV viremia 
Autoimmunity Coombs+ AIHA, ITP, autoimmune neutropenia Coombs+ AIHA, ITP Anti-ADAMTS13+ microangiopathic hemolytic anemia 
Lymphoproliferation Lymphadenopathy, splenomegaly Lymphadenopathy, splenomegaly Lymphadenopathy, splenomegaly 
Lung disease Chronic lung disease, bronchiectasis Chronic lung disease, bronchiectasis No 
Others Red-brown rash on face and legs Diplegic cerebral palsy due to congenital toxoplasmosis, red-brown rash on forearm No 
Treatment Steroids, IgG-RT, splenectomy Steroids, IgG-RT Steroids, plasmapheresis 
Outcome Died at 9 yr due to disseminated CMV infection Alive, 8 yr old, 13 mo after HSCT Died at 2 yr due to TTP 
Immunoglobulins Progressive hypogammaglobulinemia Progressive hypogammaglobulinemia Hypergammaglobulinemia 
<4 yr: <3.5 yr:  
normal normal to rather increased  
4 yr: 3.5 yr: 2 yr: 
IgG 1.6 g/liter (5.4–13.4 g/liter) IgG 1.3 g/liter (5.4–13.4 g/liter) IgG 20.45 g/liter (4.7–12.3 g/liter) 
IgA <0.16 g/liter (0.3–1.9 g/liter) IgA 0.69 g/liter (0.3–1.9 g/liter) IgA 1.02 g/liter (0.2–1.4 g/liter) 
IgM 0.12 g/liter (0.4–1.7 g/liter) IgM 0.84 g/liter (0.4–1.7 g/liter) IgM 0.89 g/liter (0.4–1.5 g/liter) 
IgE 2 IU/ml (<58 IU/ml)  IgE 286 IU/ml (<29 IU/ml) 
  8 yr:  
  IgG <2 g/liter (6.5–15.3 g/liter)  
  IgA <0.26 g/liter (0.5–2.5 g/liter)  
  IgM 0.39 g/liter (0.4–1.9 g/liter)  
Specific antibodies Hepatitis A+, HSV1+, Hepatitis B, measles, mumps, rubella ND rubella+, measles, EBV+, CMV 
Lymphocyte populations Progressive lymphopenia, high γδ T cells, low CD4 T cells Progressive lymphopenia, high γδ T cells, low CD4 T cells, low B cells High γδ T cells 
Patient 1, malePatient 2, malePatient 3, female
Age at presentation 5 mo 6 mo 10 mo 
Infection Recurrent pneumonia, EBV/CMV viremia, CMV pneumonia Congenital toxoplasmosis, recurrent pneumonia, varicella infection, CMV viremia, Candida pneumonia adenovirus + CMV PCR positive in BAL Recurrent pneumonia, urinary infections, gastroenteritis, CMV viremia 
Autoimmunity Coombs+ AIHA, ITP, autoimmune neutropenia Coombs+ AIHA, ITP Anti-ADAMTS13+ microangiopathic hemolytic anemia 
Lymphoproliferation Lymphadenopathy, splenomegaly Lymphadenopathy, splenomegaly Lymphadenopathy, splenomegaly 
Lung disease Chronic lung disease, bronchiectasis Chronic lung disease, bronchiectasis No 
Others Red-brown rash on face and legs Diplegic cerebral palsy due to congenital toxoplasmosis, red-brown rash on forearm No 
Treatment Steroids, IgG-RT, splenectomy Steroids, IgG-RT Steroids, plasmapheresis 
Outcome Died at 9 yr due to disseminated CMV infection Alive, 8 yr old, 13 mo after HSCT Died at 2 yr due to TTP 
Immunoglobulins Progressive hypogammaglobulinemia Progressive hypogammaglobulinemia Hypergammaglobulinemia 
<4 yr: <3.5 yr:  
normal normal to rather increased  
4 yr: 3.5 yr: 2 yr: 
IgG 1.6 g/liter (5.4–13.4 g/liter) IgG 1.3 g/liter (5.4–13.4 g/liter) IgG 20.45 g/liter (4.7–12.3 g/liter) 
IgA <0.16 g/liter (0.3–1.9 g/liter) IgA 0.69 g/liter (0.3–1.9 g/liter) IgA 1.02 g/liter (0.2–1.4 g/liter) 
IgM 0.12 g/liter (0.4–1.7 g/liter) IgM 0.84 g/liter (0.4–1.7 g/liter) IgM 0.89 g/liter (0.4–1.5 g/liter) 
IgE 2 IU/ml (<58 IU/ml)  IgE 286 IU/ml (<29 IU/ml) 
  8 yr:  
  IgG <2 g/liter (6.5–15.3 g/liter)  
  IgA <0.26 g/liter (0.5–2.5 g/liter)  
  IgM 0.39 g/liter (0.4–1.9 g/liter)  
Specific antibodies Hepatitis A+, HSV1+, Hepatitis B, measles, mumps, rubella ND rubella+, measles, EBV+, CMV 
Lymphocyte populations Progressive lymphopenia, high γδ T cells, low CD4 T cells Progressive lymphopenia, high γδ T cells, low CD4 T cells, low B cells High γδ T cells 

AIHA, autoimmune hemolytic anemia; BAL, bronchoalveolar lavage; HSCT, hematopoietic stem cell transplantation; IgG-RT, Ig replacement therapy; ITP, idiopathic thrombocytopenic purpura; TTP, thrombotic thrombocytopenic purpura. Values in parentheses depict age-matched reference values.

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