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Chronic gingivitis in a new BTK mutation

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Liu AJW, Dao-Ung L-P, McDonald D, Nanan R. Chronic gingivitis in a new BTK mutation.
Eur J Haematol 2005: 75: 1–5. © Blackwell Munksgaard 2005. Abstract: 

A 5-yr-old Caucasian boy with a new mutation in Bruton's tyrosine kinase (BTK) is described. Full sequencing of the BTK gene revealed a point mutation in exon 17 resulting in an amino acid change from tryptophan to serine at location 581 of the tyrosine kinase domain. Clinically the child presented with chronic gingivitis and had no prior history of bacterial infections. Whereas serum immunoglobulin M (IgM) levels were undetectable, IgG levels were in the low normal range. The gingivitis completely resolved after intravenous immunoglobulin therapy. Lymphocyte phenotyping revealed 0.05% B cells in his peripheral blood, which were IgG, IgM+, IgD+, CD38+, CD20+, CD27. However, 40% of the B cells also expressed CD5. This subpopulation of B cells has not previously been described in X-linked agammaglobulinaemia (XLA) patients. We suggest that the occurrence of CD5+ B cells could correlate with a late onset and mild clinical presentations of XLA.
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Keywords: Bruton's tyrosine kinase; CD5+ B cells; X-linked agammaglobulinaemia; gingivitis

Document Type: Research Article

Affiliations: 1: Paediatrics 2: Pathology, Nepean Hospital, Western Clinical School, University of Sydney, Sydney, NSW 3: Department of Haematology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW, Australia

Publication date: February 1, 2006

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