Dysregulation of the immune system in Aicardi-Goutières syndrome: another example in a TREX1-mutated patient

Author:

Olivieri I1,Cattalini M23,Tonduti D4,Piana R La5,Uggetti C6,Galli J7,Meini A3,Tincani A28,Moratto D9,Fazzi E27,Balottin U14,Orcesi S1

Affiliation:

1. Child Neuropsychiatry Unit, National Neurological Institute C. Mondino, Pavia, Italy

2. Department of Clinical and Experimental Sciences, University of Brescia, Italy

3. Pediatric Immunology and Rheumatology Unit, Pediatric Clinic, Spedali Civili and University of Brescia, Italy

4. Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Italy

5. Department of Neuroradiology, Montreal Neurological Institute, McGill University, Canada

6. Neuroradiology Unit, Department of Radiology, San Carlo Borromeo Hospital, Milan, Italy

7. Child Neurology and Psychiatry Unit, Clinical and Experimental Sciences Department, Spedali Civili, University of Brescia, Italy

8. Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Italy

9. Laboratory of Genetic Disorders of Childhood, “Angelo Nocivelli” Institute for Molecular Medicine, Spedali Civili of Brescia, Italy

Abstract

Aicardi-Goutières syndrome (AGS) is a rare genetic encephalopathy characterized by neurological and extraneurological involvement. A clinical overlap between AGS and systemic lupus erythematosus (SLE) has been reported. We describe an AGS patient who developed autoimmune manifestations: thyroiditis, cANCA positivity, antiphospholipid antibodies and cerebral ischemia. This first description of antiphospholipid syndrome in a TREX1-mutated patient further expands the clinical spectrum of AGS. Although the clinical overlap with SLE may indicate common pathogenic mechanisms, the autoimmune manifestations in AGS are so extensive that we suggest they should be considered a clinical feature of the disease, rather than a sign of coexistent SLE.

Publisher

SAGE Publications

Subject

Rheumatology

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