| Abstract- LPS-Responsive Beige-like Anchor (LRBA) deficiency is a disease which has recently been
described in a group of patients with common variable immunodeficiency (CVID) in association with
autoimmunity and/or inflammatory bowel disease (IBD)-like phenotype. We here describe a 10-year-old boy
who experienced recurrent infections, mainly in the respiratory system, associated with thrombocytopenia
and anemia. Immunological workup showed low numbers of B cells and low IgG, but normal IgM levels. In
spite of therapeutic doses of antibiotics, antivirals, and antifungal agents, in addition to immunoglobulin
Abstract- LPS-Responsive Beige-like Anchor (LRBA) deficiency is a disease which has recently been
described in a group of patients with common variable immunodeficiency (CVID) in association with
autoimmunity and/or inflammatory bowel disease (IBD)-like phenotype. We here describe a 10-year-old boy
who experienced recurrent infections, mainly in the respiratory system, associated with thrombocytopenia
and anemia. Immunological workup showed low numbers of B cells and low IgG, but normal IgM levels. In
spite of therapeutic doses of antibiotics, antivirals, and antifungal agents, in addition to immunoglobulin
replacement therapy, he developed disseminated involvement of both lungs with peripheral nodules; transbronchial lung biopsy revealed possible bronchiolitis obliterans organizing pneumonia (BOOP). Combined homozygosity mapping and exome sequencing identified a homozygous LRBA mutation in this patient (p.Asp248Glufs*2). Such clinical and immunological findings have not been described to date and illustrate the broad and variable clinical phenotype of human LRBA deficiency. |