Table 1.

Molecular characterization of two siblings with DCLRE1C variants

Age at diagnosis–years 28 25 
Sex Sister Brother 
Clinical diagnosis CID–leaky SCID 
Genetic variant Compound heterozygous:
Gene: DCLRE1C (Artemis)
Refseq: NM_001033855.3
Variant 1 (maternal): Missense variant. c.58 G>C, p.Asp20His
Variant 2 (paternal): NC_000010.10:g(?14984299)(15062294?)del
Deletion of around 80 kb, which includes exons 1–3 in DCLRE1C
ACMG classification: 5 
Malignancy Cervical carcinoma in situ Aggressive B cell lymphoma 
Age at diagnosis–years 28 25 
Sex Sister Brother 
Clinical diagnosis CID–leaky SCID 
Genetic variant Compound heterozygous:
Gene: DCLRE1C (Artemis)
Refseq: NM_001033855.3
Variant 1 (maternal): Missense variant. c.58 G>C, p.Asp20His
Variant 2 (paternal): NC_000010.10:g(?14984299)(15062294?)del
Deletion of around 80 kb, which includes exons 1–3 in DCLRE1C
ACMG classification: 5 
Malignancy Cervical carcinoma in situ Aggressive B cell lymphoma 
Immunological profileSisterBrotherUnitRef. interval
CD3+ (T cells) 0.52* 0.11* ×109/L 0.65–1.57 
CD19+ (B cells) 0.01* <0.01* ×109/L 0.08–0.28 
CD16+/56+ CD3(NK cells) 0.17 0.62* ×109/L 0.1–0.35 
CD3+CD4+ (Th cells) 0.46* 0.07* ×109/L 0.49–1.34 
CD3+CD4+ (Tc cells) 0.06* 0.02* ×109/L 0.19–0.8 
CD4+/CD8+ ratio 7.58* 3.31 ​ 1.13–3.93 
Regulatory T lymphocytes ​ ​ ​ ​ 
CD4+CD25+CD127 2* ​ 5–11 
Extended T cell panel—reference range based on healthy blood donors aged 18–65 years ​ ​ ​ ​ 
Subtypes of CD4+ T cells ​ ​ ​ ​ 
CD4+/CD3+ 85* 67 44–79 
CD4+naive (CD45RA+CCR7+1* <0.5* 22–62 
CD4+EM (CD45RACCR78* 56* 10–47 
CD4+CM (CD45RACCR7+91* 43 14–48 
CD4+EMRA (CD45RA+CCR7<0.5* <0.5* 1–9 
Th1 (CXCR3+CCR6)/CD4+EM 26 25 22–52 
Th2 (CXCR3CCR6)/CD4+EM 4–27 
Th17 (CXCR3CCR6+)/CD4+EM 16 38* 8–28 
Th1 (CXCR3+CCR6)/CD4+CM 5* 13 13–30 
Th2 (CXCR3CCR6)/CD4+CM 2* 2* 14–53 
Th17 (CXCR3CCR6+)/CD4+CM 21 43* 20–37 
Subtypes of CD8+ T cells ​ ​ ​ ​ 
CD8+/CD3+ 11* 16* 17–47 
CD8+ naive (CD45RA+CCR7+2* Not measurable 10–65 
CD8+ EM (CD45RACCR749* Not measurable 4–30 
CD8+ CM (CD45RACCR7+47* Not measurable 1–12 
CD8+ EMRA (CD45RA+CCR72* Not measurable 18–68 
Activated T cells ​ ​ ​ ​ 
CD4+HLA-DR+CD38 2–11 
CD4+HLA-DR+CD38+ 23* ≤2 
CD8+HLA-DR+CD38 Not measurable 2–22 
CD8+ HLA-DR+CD38+ Not measurable 1–5 
B lymphocyte subpopulations: Too few B lymphocytes to perform the analysis ​ ​ ​ ​ 
Immunological profileSisterBrotherUnitRef. interval
CD3+ (T cells) 0.52* 0.11* ×109/L 0.65–1.57 
CD19+ (B cells) 0.01* <0.01* ×109/L 0.08–0.28 
CD16+/56+ CD3(NK cells) 0.17 0.62* ×109/L 0.1–0.35 
CD3+CD4+ (Th cells) 0.46* 0.07* ×109/L 0.49–1.34 
CD3+CD4+ (Tc cells) 0.06* 0.02* ×109/L 0.19–0.8 
CD4+/CD8+ ratio 7.58* 3.31 ​ 1.13–3.93 
Regulatory T lymphocytes ​ ​ ​ ​ 
CD4+CD25+CD127 2* ​ 5–11 
Extended T cell panel—reference range based on healthy blood donors aged 18–65 years ​ ​ ​ ​ 
Subtypes of CD4+ T cells ​ ​ ​ ​ 
CD4+/CD3+ 85* 67 44–79 
CD4+naive (CD45RA+CCR7+1* <0.5* 22–62 
CD4+EM (CD45RACCR78* 56* 10–47 
CD4+CM (CD45RACCR7+91* 43 14–48 
CD4+EMRA (CD45RA+CCR7<0.5* <0.5* 1–9 
Th1 (CXCR3+CCR6)/CD4+EM 26 25 22–52 
Th2 (CXCR3CCR6)/CD4+EM 4–27 
Th17 (CXCR3CCR6+)/CD4+EM 16 38* 8–28 
Th1 (CXCR3+CCR6)/CD4+CM 5* 13 13–30 
Th2 (CXCR3CCR6)/CD4+CM 2* 2* 14–53 
Th17 (CXCR3CCR6+)/CD4+CM 21 43* 20–37 
Subtypes of CD8+ T cells ​ ​ ​ ​ 
CD8+/CD3+ 11* 16* 17–47 
CD8+ naive (CD45RA+CCR7+2* Not measurable 10–65 
CD8+ EM (CD45RACCR749* Not measurable 4–30 
CD8+ CM (CD45RACCR7+47* Not measurable 1–12 
CD8+ EMRA (CD45RA+CCR72* Not measurable 18–68 
Activated T cells ​ ​ ​ ​ 
CD4+HLA-DR+CD38 2–11 
CD4+HLA-DR+CD38+ 23* ≤2 
CD8+HLA-DR+CD38 Not measurable 2–22 
CD8+ HLA-DR+CD38+ Not measurable 1–5 
B lymphocyte subpopulations: Too few B lymphocytes to perform the analysis ​ ​ ​ ​ 

CD, cluster of differentiation; EM, effector memory; CM, central memory; EMRA, effector memory expressing CD45RA; Th, T helper cell; Tc, cytotoxic T cell; IgD, immunoglobulin D; IgM, immunoglobulin M.

*

Indicates values outside the reference interval (also indicated in bold).

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