Frontiers in Pediatrics (Mar 2021)

Case Report: A Novel Pathogenic Missense Mutation in FAS: A Multi-Generational Case Series of Autoimmune Lymphoproliferative Syndrome

  • Claudia L. Gaefke,
  • Jonathan Metts,
  • Donya Imanirad,
  • Daime Nieves,
  • Paola Terranova,
  • Gianluca Dell'Orso,
  • Eleonora Gambineri,
  • Maurizio Miano,
  • Richard F. Lockey,
  • Jolan Eszter Walter,
  • Jolan Eszter Walter,
  • Emma Westermann-Clark,
  • Emma Westermann-Clark

DOI
https://doi.org/10.3389/fped.2021.624116
Journal volume & issue
Vol. 9

Abstract

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Autoimmune Lymphoproliferative Syndrome (ALPS), commonly caused by mutations in the FAS gene, is a disease with variable penetrance. Subjects may be asymptomatic, or they may present with lymphadenopathy, splenomegaly, cytopenias, or malignancy. Prompt recognition of ALPS is needed for optimal management. We describe a multi-generational cohort presenting with clinical manifestations of ALPS, and a previously unreported heterozygous missense variant of uncertain significance in FAS (c.758G >T, p.G253V), located in exon 9. Knowledge of the underlying genetic defect permitted prompt targeted therapy to treat acute episodes of cytopenia. This cohort underscores the importance of genetic testing in subjects with clinical features of ALPS and should facilitate the reclassification of this variant as pathogenic.

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