Clinical and genetic features of patients harboring STAT2 variants with negative regulation
| Family | Patient | Origin | Homozygous variant | Age at onset | Neurological features | Others | ISG signature | JAK inhibitor response | Outcome | Study |
|---|---|---|---|---|---|---|---|---|---|---|
| F1 | P1 | Iran | c.443G>A p.R148Q | 6 wk | Seizure Intracranial calcifications Hemorrhage Atrophy encephalomalacia | Draining cervical adenitis Respiratory failure | Upregulated | Ruxolitinib, dramatic response to 5 mg, bid | Favorable developmental and respirator function at 24 mo 3 years old at 2025 | Current |
| F2 | P2 | Iran | c.443G>A p.R148Q | 20 days | Seizure Intracranial calcification Encephalitis Abnormal EEG | Draining adenitis Fever Respiratory failure | NA | No | Died at 8.5 years with influenza-induced respiratory failure | Current |
| F3 | P3 | Morocco | c.443G>A p.R148Q | 15 days | Seizures Intracranial calcifications | Adenitis (P. aeruginosa and K. pneumoniae) Fever PAP Respiratory failure skin ulcerations Cardiomegaly | Upregulated | No | Died at 5 mo from respiratory failure | Gruber et al. (2020) (10) |
| F4 | P4 | Pakistan | c.442C>T p.R148W | Neonatal | Seizure Intracranial calcification Hemorrhage White matter changes Neurodevelopmental delay | Thrombocytopenia Recurrent HLH-like episodes Thrombotic microangiopathy Acute kidney injury Proteinuria | Upregulated | Ruxolitinib 2.5 mg bid, clinical stabilization and improved ISG score | Died in immediate post-HSCT period with sepsis (20 mo) | Duncan et al. (2019) (9) |
| P5 | Pakistan | c.442C>T p.R148W | 3 wk | Recurrent apnea Intracranial calcification Hemorrhage White matter changes Cerebellar hypoplasia Brainstem atrophy Abnormal EEG | Preterm birth | Upregulated | Ruxolitinib 1 mg bid, partial response, improved ISG score but persistent neurodevelopmental abnormalities | Diet at 3 mo with severe neurologic impairment | Duncan et al. (2019) (9) | |
| F5 | P6 | Russia | c.442C>T p.R148W | Neonatal | Seizures Intracranial calcifications Neurodevelopmental delay | Adenitis after BCG Fever Interstitial pneumonia and bronchiolitis | NA | Tofacitinib, 20 mg per day with clinical and picture improvements | 5 years old in 2021 | Kozlova et al. (2021) (17) |
| F6 | P7 | Turkey | c.656C>T p.A219V | 5 mo | Intracranial calcifications Cerebral atrophy Delayed motor and speech Spastic paraparesis Stroke-like episodes of hemiparesis Pontine hemorrhage dystonia | Fever Abnormal liver function | Upregulated Tested by qPCR and NanoString assays | No | Severe neurologic sequelae at 20 years | Zhu et al. (2023) (11) |
| Family | Patient | Origin | Homozygous variant | Age at onset | Neurological features | Others | ISG signature | JAK inhibitor response | Outcome | Study |
|---|---|---|---|---|---|---|---|---|---|---|
| F1 | P1 | Iran | c.443G>A p.R148Q | 6 wk | Seizure | Draining cervical adenitis | Upregulated | Ruxolitinib, dramatic response to 5 mg, bid | Favorable developmental and respirator function at 24 mo | Current |
| F2 | P2 | Iran | c.443G>A p.R148Q | 20 days | Seizure | Draining adenitis | NA | No | Died at 8.5 years with influenza-induced respiratory failure | Current |
| F3 | P3 | Morocco | c.443G>A p.R148Q | 15 days | Seizures | Adenitis ( | Upregulated | No | Died at 5 mo from respiratory failure | Gruber et al. (2020) ( |
| F4 | P4 | Pakistan | c.442C>T p.R148W | Neonatal | Seizure | Thrombocytopenia | Upregulated | Ruxolitinib 2.5 mg bid, clinical stabilization and improved ISG score | Died in immediate post-HSCT period with sepsis (20 mo) | Duncan et al. (2019) ( |
| P5 | Pakistan | c.442C>T p.R148W | 3 wk | Recurrent apnea | Preterm birth | Upregulated | Ruxolitinib 1 mg bid, partial response, improved ISG score but persistent neurodevelopmental abnormalities | Diet at 3 mo with severe neurologic impairment | Duncan et al. (2019) ( | |
| F5 | P6 | Russia | c.442C>T p.R148W | Neonatal | Seizures | Adenitis after BCG | NA | Tofacitinib, 20 mg per day with clinical and picture improvements | 5 years old in 2021 | Kozlova et al. (2021) ( |
| F6 | P7 | Turkey | c.656C>T p.A219V | 5 mo | Intracranial calcifications | Fever | Upregulated | No | Severe neurologic sequelae at 20 years | Zhu et al. (2023) ( |
HLH, hemophagocytic lymphohistiocytosis; mo, months; wk, week.