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Immunodeficiency 75(IMD75)

MedGen UID:
1741014
Concept ID:
C5436860
Disease or Syndrome
Synonym: IMMUNODEFICIENCY 75 WITH LYMPHOPROLIFERATION
 
Gene (location): TET2 (4q24)
 
Monarch Initiative: MONDO:0030858
OMIM®: 619126

Definition

Immunodeficiency-75 with lymphoproliferation (IMD75) is an autosomal recessive immunologic disorder characterized by immunodeficiency, immune dysregulation, and the development of lymphoproliferative disorders, including lymphoma. Affected individuals usually present in infancy with severe and recurrent infections, mainly viral and affecting the respiratory tract. Some patients may have autoimmune cytopenias, anemia, or thrombocytopenia. Patients also develop hepatosplenomegaly, lymphadenopathy, lymphoproliferative disorders, and various types of T- or B-cell lymphomas. Immunologic work-up shows decreased class-switched B cells, impaired B-cell terminal differentiation, and hypo- or hypergammaglobulinemia. There is skewed differentiation and dysregulation of T cells, as well as possibly disrupted hematopoiesis. Additional features include failure to thrive and global developmental delay. The phenotype may be reminiscent of ALPS (601859), including laboratory evidence of impaired Fas-dependent T-cell apoptosis. Although hematopoietic stem cell transplantation may be effective treatment, many patients die in childhood (summary by Stremenova Spegarova et al., 2020). [from OMIM]

Clinical features

From HPO
Lymphoma
MedGen UID:
44223
Concept ID:
C0024299
Neoplastic Process
A cancer originating in lymphocytes and presenting as a solid tumor of lymhpoid cells.
Hepatosplenomegaly
MedGen UID:
9225
Concept ID:
C0019214
Sign or Symptom
Simultaneous enlargement of the liver and spleen.
Moderate global developmental delay
MedGen UID:
500807
Concept ID:
C2237142
Finding
A moderate delay in the achievement of motor or mental milestones in the domains of development of a child.
Bronchiectasis
MedGen UID:
14234
Concept ID:
C0006267
Disease or Syndrome
Persistent abnormal dilatation of the bronchi owing to localized and irreversible destruction and widening of the large airways.
Recurrent respiratory infections
MedGen UID:
812812
Concept ID:
C3806482
Finding
An increased susceptibility to respiratory infections as manifested by a history of recurrent respiratory infections.
Lymphadenopathy
MedGen UID:
96929
Concept ID:
C0497156
Disease or Syndrome
Enlargement (swelling) of a lymph node.
Persistent EBV viremia
MedGen UID:
767466
Concept ID:
C3554552
Finding
Persistent presence of Epstein-Barr virus in the blood.
Follicular hyperplasia
MedGen UID:
863170
Concept ID:
C4014733
Finding
Lymphadenopathy (enlargement of lymph nodes) owing to hyperplasia of follicular (germinal) centers.
Decreased class-switched memory B cell proportion
MedGen UID:
892709
Concept ID:
C4072925
Finding
A reduction in the normal proportion of class-switched memory B cells (CD19+/CD27+/IgM+/IgD+) relative to the total number of B cells. Marginal zone B cells undergo limited somatic hypermutation and produce high-affinity IgM and some IgG, whereas class-switched memory B cells synthetize IgG, IgM, and IgA.
Decreased FasL-mediated apoptosis
MedGen UID:
1788667
Concept ID:
C5539888
Cell or Molecular Dysfunction
A reduced amount of programmed cell death upon stimulation of the FAS receptor, which normally induces caspase-8 dependent apoptosis.

Professional guidelines

PubMed

Rock AE, Russell ML, Triant VA
Curr Opin HIV AIDS 2025 Jul 1;20(4):409-415. Epub 2025 May 13 doi: 10.1097/COH.0000000000000948. PMID: 40397570Free PMC Article
Böhm S, Wustrau K, Pachlopnik Schmid J, Prader S, Ahlmann M, Yacobovich J, Beier R, Speckmann C, Behnisch W, Ifversen M, Jordan M, Marsh R, Naumann-Bartsch N, Mauz-Körholz C, Hönig M, Schulz A, Malinowska I, Hines M, Nichols KE, Gil-Herrera J, Talano JA, Crooks B, Formankova R, Jorch N, Bakhtiar S, Kühnle I, Streiter M, Nathrath M, Russo A, Dürken M, Lang P, Lindemans C, Henter JI, Lehmberg K, Ehl S
Blood 2024 Mar 7;143(10):872-881. doi: 10.1182/blood.2023022281. PMID: 37992218
Ackerman AL, Parameshwar PS, Anger JT
Int J Urol 2018 Feb;25(2):103-110. Epub 2017 Sep 24 doi: 10.1111/iju.13451. PMID: 28944509

Recent clinical studies

Etiology

Batista CHR, Smanio MCM, Poltronieri PB, Resende LL, Kokron CM, Barros MT, Agondi RC, Ferraroni NR, Roxo-Junior P, Ferriani MPL, Chong-Neto H, Rosario Filho N, Kamoi TO, Di Gesu R, Goudouris E, Aranda CS, Mansour E, Henriques MT, Bardou MLD, Antila HG, Grumach AS
Immunol Res 2024 Dec 16;73(1):15. doi: 10.1007/s12026-024-09568-4. PMID: 39680289
Zhang B, Fan J, Huang C, Fan H, Chen J, Huang X, Zeng X
J Clin Immunol 2023 Oct;43(7):1660-1670. Epub 2023 Jun 26 doi: 10.1007/s10875-023-01537-0. PMID: 37365453Free PMC Article
Stohl W, Schwarting A, Okada M, Scheinberg M, Doria A, Hammer AE, Kleoudis C, Groark J, Bass D, Fox NL, Roth D, Gordon D
Arthritis Rheumatol 2017 May;69(5):1016-1027. Epub 2017 Apr 7 doi: 10.1002/art.40049. PMID: 28118533Free PMC Article
Deeks SG, Overbaugh J, Phillips A, Buchbinder S
Nat Rev Dis Primers 2015 Oct 1;1:15035. doi: 10.1038/nrdp.2015.35. PMID: 27188527
Jaffe HW
J Am Acad Dermatol 1990 Jun;22(6 Pt 2):1167-71. doi: 10.1016/0190-9622(90)70159-f. PMID: 2193943

Diagnosis

Zhang B, Fan J, Huang C, Fan H, Chen J, Huang X, Zeng X
J Clin Immunol 2023 Oct;43(7):1660-1670. Epub 2023 Jun 26 doi: 10.1007/s10875-023-01537-0. PMID: 37365453Free PMC Article
Perez E
Clin Rev Allergy Immunol 2022 Aug;63(1):75-89. Epub 2022 Jan 12 doi: 10.1007/s12016-021-08916-8. PMID: 35020169Free PMC Article
Karthikeyan K
Indian J Dermatol Venereol Leprol 2009 Jul-Aug;75(4):340-7. doi: 10.4103/0378-6323.53128. PMID: 19584457
Scarlatti G
Lancet 1996 Sep 28;348(9031):863-8. doi: 10.1016/S0140-6736(95)11030-5. PMID: 8826814
Jaffe HW
J Am Acad Dermatol 1990 Jun;22(6 Pt 2):1167-71. doi: 10.1016/0190-9622(90)70159-f. PMID: 2193943

Therapy

Pettit AC, Phillips PPJ, Kurbatova E, Vernon A, Nahid P, Dawson R, Dooley KE, Sanne I, Waja Z, Mohapi L, Podany AT, Samaneka W, Savic RM, Johnson JL, Muzanyi G, Lalloo UG, Bryant K, Sizemore E, Scott N, Dorman SE, Chaisson RE, Swindells S; Tuberculosis Trials Consortium (TBTC) Study 31/AIDS Clinical Trials Group (ACTG) A5349 study team
Clin Infect Dis 2023 Feb 8;76(3):e580-e589. doi: 10.1093/cid/ciac707. PMID: 36041016Free PMC Article
Grinspoon SK, Fitch KV, Overton ET, Fichtenbaum CJ, Zanni MV, Aberg JA, Malvestutto C, Lu MT, Currier JS, Sponseller CA, Waclawiw M, Alston-Smith B, Cooper-Arnold K, Klingman KL, Desvigne-Nickens P, Hoffmann U, Ribaudo HJ, Douglas PS; REPRIEVE Investigators
Am Heart J 2019 Jun;212:23-35. Epub 2019 Mar 4 doi: 10.1016/j.ahj.2018.12.016. PMID: 30928825Free PMC Article
Giovannoni G, Soelberg Sorensen P, Cook S, Rammohan K, Rieckmann P, Comi G, Dangond F, Adeniji AK, Vermersch P
Mult Scler 2018 Oct;24(12):1594-1604. Epub 2017 Sep 5 doi: 10.1177/1352458517727603. PMID: 28870107
Stohl W, Schwarting A, Okada M, Scheinberg M, Doria A, Hammer AE, Kleoudis C, Groark J, Bass D, Fox NL, Roth D, Gordon D
Arthritis Rheumatol 2017 May;69(5):1016-1027. Epub 2017 Apr 7 doi: 10.1002/art.40049. PMID: 28118533Free PMC Article
Deeks SG, Overbaugh J, Phillips A, Buchbinder S
Nat Rev Dis Primers 2015 Oct 1;1:15035. doi: 10.1038/nrdp.2015.35. PMID: 27188527

Prognosis

GBD 2021 HIV Collaborators
Lancet HIV 2024 Dec;11(12):e807-e822. Epub 2024 Nov 25 doi: 10.1016/S2352-3018(24)00212-1. PMID: 39608393Free PMC Article
Bassat Q, Blau DM, Ogbuanu IU, Samura S, Kaluma E, Bassey IA, Sow S, Keita AM, Tapia MD, Mehta A, Kotloff KL, Rahman A, Islam KM, Alam M, El Arifeen S, Gurley ES, Baillie V, Mutevedzi P, Mahtab S, Thwala BN, Tippett Barr BA, Onyango D, Akelo V, Rogena E, Onyango P, Omore R, Mandomando I, Ajanovic S, Varo R, Sitoe A, Duran-Frigola M, Assefa N, Scott JAG, Madrid L, Tesfaye T, Dessie Y, Madewell ZJ, Breiman RF, Whitney CG, Madhi SA; Child Health and Mortality Prevention Surveillance (CHAMPS) Network
JAMA Netw Open 2023 Jul 3;6(7):e2322494. doi: 10.1001/jamanetworkopen.2023.22494. PMID: 37494044Free PMC Article
Zhang B, Fan J, Huang C, Fan H, Chen J, Huang X, Zeng X
J Clin Immunol 2023 Oct;43(7):1660-1670. Epub 2023 Jun 26 doi: 10.1007/s10875-023-01537-0. PMID: 37365453Free PMC Article
Garg RK
Acta Neurol Scand 2010 Aug;122(2):75-90. Epub 2010 Jan 6 doi: 10.1111/j.1600-0404.2009.01316.x. PMID: 20055767
Schuman P, Sobel JD
Aust N Z J Obstet Gynaecol 1993 Nov;33(4):341-50. doi: 10.1111/j.1479-828x.1993.tb02106.x. PMID: 8179538

Clinical prediction guides

Batista CHR, Smanio MCM, Poltronieri PB, Resende LL, Kokron CM, Barros MT, Agondi RC, Ferraroni NR, Roxo-Junior P, Ferriani MPL, Chong-Neto H, Rosario Filho N, Kamoi TO, Di Gesu R, Goudouris E, Aranda CS, Mansour E, Henriques MT, Bardou MLD, Antila HG, Grumach AS
Immunol Res 2024 Dec 16;73(1):15. doi: 10.1007/s12026-024-09568-4. PMID: 39680289
Soares C, Kwok M, Boucher KA, Haji M, Echouffo-Tcheugui JB, Longenecker CT, Bloomfield GS, Ross D, Jutkowtiz E, Sullivan JL, Rudolph JL, Wu WC, Erqou S
JAMA Cardiol 2023 Feb 1;8(2):139-149. doi: 10.1001/jamacardio.2022.4873. PMID: 36576812Free PMC Article
Asai N, Motojima S, Ohkuni Y, Matsunuma R, Nakashita T, Kaneko N, Mikamo H
Respir Investig 2022 Jul;60(4):522-530. Epub 2022 Apr 29 doi: 10.1016/j.resinv.2022.04.002. PMID: 35501264
Stohl W, Schwarting A, Okada M, Scheinberg M, Doria A, Hammer AE, Kleoudis C, Groark J, Bass D, Fox NL, Roth D, Gordon D
Arthritis Rheumatol 2017 May;69(5):1016-1027. Epub 2017 Apr 7 doi: 10.1002/art.40049. PMID: 28118533Free PMC Article
Schuman P, Sobel JD
Aust N Z J Obstet Gynaecol 1993 Nov;33(4):341-50. doi: 10.1111/j.1479-828x.1993.tb02106.x. PMID: 8179538

Recent systematic reviews

Jin F, Vajdic CM, Poynten IM, McGee-Avila JK, Castle PE, Grulich AE
Lancet Oncol 2024 Jul;25(7):933-944. doi: 10.1016/S1470-2045(24)00189-X. PMID: 38936380Free PMC Article
Wang W, Zhao S, Wu Y, Duan W, Li S, Li Z, Guo C, Wang W, Zhang T, Wu H, Huang X
JMIR Public Health Surveill 2023 Jul 27;9:e46767. doi: 10.2196/46767. PMID: 37498645Free PMC Article
Sultana ZZ, Hoque FU, Beyene J, Akhlak-Ul-Islam M, Khan MHR, Ahmed S, Hawlader DH, Hossain A
BMC Infect Dis 2021 Jan 11;21(1):51. doi: 10.1186/s12879-020-05749-2. PMID: 33430786Free PMC Article
Hemelaar J, Elangovan R, Yun J, Dickson-Tetteh L, Fleminger I, Kirtley S, Williams B, Gouws-Williams E, Ghys PD; WHO–UNAIDS Network for HIV Isolation Characterisation
Lancet Infect Dis 2019 Feb;19(2):143-155. Epub 2018 Nov 30 doi: 10.1016/S1473-3099(18)30647-9. PMID: 30509777
Prasad K, Singh MB, Ryan H
Cochrane Database Syst Rev 2016 Apr 28;4(4):CD002244. doi: 10.1002/14651858.CD002244.pub4. PMID: 27121755Free PMC Article

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