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Griscelli syndrome without hemophagocytosis in an eleven‐year‐old girl: Expanding the phenotypic spectrum of Rab27A mutations in humans
Author(s) -
Aksu Güzide,
Kütükçüler Necil,
Genel Ferah,
Vergin Canan,
Omowaire Benjamin
Publication year - 2002
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.10836
Subject(s) - hemophagocytosis , hepatosplenomegaly , medicine , pediatrics , cytopenia , immunodeficiency , pathology , bone marrow , pancytopenia , immunology , disease , immune system
We present an eleven‐year‐old female patient who was referred to us with silvery hair, hepatosplenomegaly, neutropenia‐thrombocytopenia, hypogammaglobulinemia and degenerative white matter disease, with a family history of a female sibling dying at the age of five and two living male cousins, ages 10 and 11. She had been followed up for her cytopenia the last three years and had totally recovered from a hemiplegic episode before admission. The family was of Arabic origin, and a second‐degree consanguinity was reported between the parents. Microscopic analysis of her hair shafts revealed irregularly distributed small and large clumps of melanin, and skin biopsy findings were consistent with partial albinism. Bone marrow aspiration and biopsy did not detect any evidence of hemophagocytosis. Genetic analysis identified a homozygous two‐base‐pair deletion (51 del CT leading to S18X) in the Rab27A gene of the patient. She suffered from febrile neutropenic episodes. Her persistent cytopenia could not be corrected with immunoglobulin, thrombocyte infusions, or a short course of growth factor treatment. Splenectomy was planned due to her progressive splenic enlargement. She was also considered for bone marrow transplantation. She unfortunately died from an intracranial hemorrhage. Her clinical presentation was remarkable, mostly resembling partial albinism immunodeficiency/Elejalde syndrome due to her older age and absence of hemophagocytosis, but with molecular findings confirming Griscelli syndrome. © 2002 Wiley‐Liss, Inc.