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X-linked agammaglobulinemia (XLA) is a rare primary immunodeficiency disorder caused by mutations in the Bruton tyrosine kinase (BTK) gene. This article presents a fatal case of a 20-year-old male with XLA complicated by septic shock due to infection, highlighting two novel BTK insertion mutations in exon 15 (NM_000061.3 exon15:c.1561insG and c.1565insTAGAA). Concurrently, we provide a systematic review of XLA's genetic basis, clinical manifestations, diagnostic challenges, and therapeutic advancements. The patient's delayed diagnosis, lack of immunoglobulin replacement therapy, and fatal outcome underscore the importance of early genetic screening and standardized management. This case and review aim to enhance clinical awareness and emphasize the integration of genetic diagnostics into routine practice for primary immunodeficiencies.
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http://dx.doi.org/10.3389/fimmu.2025.1645337 | DOI Listing |
Front Immunol
September 2025
School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, China.
X-linked agammaglobulinemia (XLA) is a rare primary immunodeficiency disorder caused by mutations in the Bruton tyrosine kinase (BTK) gene. This article presents a fatal case of a 20-year-old male with XLA complicated by septic shock due to infection, highlighting two novel BTK insertion mutations in exon 15 (NM_000061.3 exon15:c.
View Article and Find Full Text PDFClin Immunol
August 2025
Unit of Pediatric Immunology, Pediatrics Clinic, University of Brescia; Department of Clinical and Experimental Sciences University of Brescia, ASST Spedali Civili Brescia, Italy; European Reference Network on Rare Primary Immunodeficiency, Autoinflammatory and Autoimmune Diseases (ERN-RITA), Utrech
We report the case of a young boy with X-linked agammaglobulinemia (XLA) who developed progressive gait instability and postural difficulties. Initial cerebrospinal fluid (CSF) analyses and viral PCR testing were negative; however, a brain biopsy confirmed chronic enteroviral encephalitis. The patient was treated with two compassionate-use cycles of pocapavir, in combination with ongoing high-dose intravenous immunoglobulin (IVIG) therapy.
View Article and Find Full Text PDFJ Pers Med
August 2025
Unidad de Investigación en Virología y Cáncer, Hospital Infantil de México "Federico Gómez", México City 06720, Mexico.
: X-linked agammaglobulinemia (XLA) is a prototypical inborn error of immunity (IEI) caused by mutations in the gene, leading to a profound deficiency of mature B cells and severe pan-hypogammaglobulinemia. The Epstein-Barr virus (EBV), which primarily infects B lymphocytes, is believed to be unable to establish persistence in these patients due to the lack of its natural reservoir. Indeed, current evidence supports that EBV infection is typically refractory in individuals with XLA.
View Article and Find Full Text PDFJ Med Virol
September 2025
Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
COVID-19 has worse clinical outcomes in inborn errors of immunity (IEI) patients. We aimed to determine COVID-19-related hospitalization/ICU admission/mortality risk in patients with IEI. We included 62 COVID-19 (29 children and 33 adults) in a referral center.
View Article and Find Full Text PDFThromb Haemost
August 2025
FSBIS Center for Theoretical Problems of Physico-Chemical Pharmacology of the Russian Academy of Sciences, Moscow, Russian Federation.
Objectives Microfluidic assays offer a promising solution for accessing the state of the hemostasis system, testing drugs and adjusting anticoagulant dosages. However, standardisation of such assays is still missing. We aimed to design a robust and readily accessible microfluidic assay, which follows recent SSC guidelines and is sensitive to hemostatic abnormalities.
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