An 18-year-old woman with pulmonary nodules found to have cytotoxic T-lymphocyte-associated antigen 4 deficiency

BMJ Case Rep. 2019 Dec 8;12(12):e231600. doi: 10.1136/bcr-2019-231600.

Abstract

An 18-year-old woman was admitted with abdominal pain and hematochezia. She was previously healthy until 15 years of age and was subsequently diagnosed with hypogammaglobulinemia, protein-losing enteropathy, a benign temporal lobe brain lesion/orbital fibroadenoma, autoimmune hepatitis, iron deficiency anaemia and hypothyroidism. She developed respiratory distress and hypoxemia. She was found to have nodules on chest CT scan. She was diagnosed with cytotoxic T-lymphocyte-associated antigen 4 deficiency via genetic testing.

Keywords: immunology; respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Abatacept / therapeutic use
  • Abdominal Pain / etiology
  • Adolescent
  • CTLA-4 Antigen / deficiency*
  • Diagnosis, Differential
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Multiple Pulmonary Nodules / diagnostic imaging*
  • Multiple Pulmonary Nodules / drug therapy
  • Multiple Pulmonary Nodules / immunology
  • Sirolimus / therapeutic use
  • Treatment Outcome

Substances

  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Immunosuppressive Agents
  • Abatacept
  • Sirolimus