Biliary cirrhosis in a child with inherited interleukin-12 deficiency.

Interleukin-12 (IL-12) is a key cytokine in the defense against intracellular bacteria notably Mycobacteria and Salmonella species. We report a case of disseminated mycobacterial infection, following BCG vaccination, in a child who later developed tuberculosis. Functional tests and a novel diagnosti...

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Main Authors: Pulickal, A, Hambleton, S, Callaghan, M, Moore, C, Goulding, J, Goodsall, A, Baretto, R, Lammas, D, Anderson, S, Levin, M, Pollard, A
Format: Journal article
Language:English
Published: 2008
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author Pulickal, A
Hambleton, S
Callaghan, M
Moore, C
Goulding, J
Goodsall, A
Baretto, R
Lammas, D
Anderson, S
Levin, M
Pollard, A
author_facet Pulickal, A
Hambleton, S
Callaghan, M
Moore, C
Goulding, J
Goodsall, A
Baretto, R
Lammas, D
Anderson, S
Levin, M
Pollard, A
author_sort Pulickal, A
collection OXFORD
description Interleukin-12 (IL-12) is a key cytokine in the defense against intracellular bacteria notably Mycobacteria and Salmonella species. We report a case of disseminated mycobacterial infection, following BCG vaccination, in a child who later developed tuberculosis. Functional tests and a novel diagnostic polymerase chain reaction (PCR) assay, revealed a loss-of-function deletion in the IL12 gene. Analysis of samples from the parents and siblings of the patient indicated an autosomal recessive inheritance pattern with varying degrees of phenotypic expression in identical genotypes. Interferon-gamma (IFN-gamma) therapy was associated with marked clinical improvement. Biliary cirrhosis, a hitherto unreported complication of IL-12 deficiency, developed later and required liver transplantation. A defect in the IL-12-IFN-gamma pathway should be suspected in patients presenting with multiple, repeated or persistent infection with intracellular bacteria. The diagnostic work-up and the immuno-genetic assay described here can aid in the quick and reliable diagnosis of IL-12 deficiency resulting from genetic defects and its subsequent management.
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spelling oxford-uuid:bdd29a69-197e-4d25-a036-479fedf87e482022-03-27T05:34:41ZBiliary cirrhosis in a child with inherited interleukin-12 deficiency.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bdd29a69-197e-4d25-a036-479fedf87e48EnglishSymplectic Elements at Oxford2008Pulickal, AHambleton, SCallaghan, MMoore, CGoulding, JGoodsall, ABaretto, RLammas, DAnderson, SLevin, MPollard, AInterleukin-12 (IL-12) is a key cytokine in the defense against intracellular bacteria notably Mycobacteria and Salmonella species. We report a case of disseminated mycobacterial infection, following BCG vaccination, in a child who later developed tuberculosis. Functional tests and a novel diagnostic polymerase chain reaction (PCR) assay, revealed a loss-of-function deletion in the IL12 gene. Analysis of samples from the parents and siblings of the patient indicated an autosomal recessive inheritance pattern with varying degrees of phenotypic expression in identical genotypes. Interferon-gamma (IFN-gamma) therapy was associated with marked clinical improvement. Biliary cirrhosis, a hitherto unreported complication of IL-12 deficiency, developed later and required liver transplantation. A defect in the IL-12-IFN-gamma pathway should be suspected in patients presenting with multiple, repeated or persistent infection with intracellular bacteria. The diagnostic work-up and the immuno-genetic assay described here can aid in the quick and reliable diagnosis of IL-12 deficiency resulting from genetic defects and its subsequent management.
spellingShingle Pulickal, A
Hambleton, S
Callaghan, M
Moore, C
Goulding, J
Goodsall, A
Baretto, R
Lammas, D
Anderson, S
Levin, M
Pollard, A
Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title_full Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title_fullStr Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title_full_unstemmed Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title_short Biliary cirrhosis in a child with inherited interleukin-12 deficiency.
title_sort biliary cirrhosis in a child with inherited interleukin 12 deficiency
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