Omenn Syndrome Caused by A Novel Mutation of the DCLRE1C Gene: Case Report and Review of Literature

Taher Cheraghi; Afshin Safaee; Ebrahim Esmaili; Kiomars Golshekan; Maryam x Maryam Ghavideldarestani

doi:10.18502/igj.v4i3.12113

Taher Cheraghi 17th Shahrivar Children’s Hospital, Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Afshin Safaee 17th Shahrivar Children’s Hospital, Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Ebrahim Esmaili 17th Shahrivar Children’s Hospital, Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Kiomars Golshekan 17th Shahrivar Children’s Hospital, Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Maryam x Maryam Ghavideldarestani Hull York Medical School, Cottingham Road, Hull, HU67RX, UK

DOI: https://doi.org/10.18502/igj.v4i3.12113

Keywords: DCLRE1C Mutation; Omenn Syndrome; Erythematoexfoliative Rash; Esosinophilia

Abstract

We report a case of Omenn syndrome due to a novel mutation of the gene DCLRE1C(Artemis). He was referred to our hospital with a complaint of protracted diarrhea, erythematoexfoliative rash, urinary tract infection, pneumonia, and failure to thrive. He was 2 months old. At the first sight, the diagnoses of Omenn syndrome, graft versus host disease (GVHD), Netherton syndrome, and Atopic dermatitis came to mind. Laboratory evaluation showed lymphopenia, eosinophilia, high IgE, and whole-exome sequencing revealed a mutation of the DCLRE1C gene. After obtaining blood samples, he received broad-spectrum antibiotics, antifungals, antiviral, prophylaxis for pneumocystis Jirovecii pneumonia, and Intravenous immunoglobulin. He expired owing to delayed referral and overwhelming sepsis before receiving bone marrow transplantation. In every neonate infant presenting with erythematoexfoliative skin rash, refractory infection, and lymphopenia, Omenn syndrome should be considered.