An Unexpected Infection in Loss-of-Function Mutations in STAT3: Malignant Alveolar Echinococcosis in Liver

Iran J Allergy Asthma Immunol. 2020 Dec 19;19(6):667-675. doi: 10.18502/ijaai.v19i6.4936.

Abstract

Loss-of-function (LOF) mutations in signal transducer and activator of transcription 3 (STAT3) gene causes autosomal dominant hyper immunoglobulin E syndrome (AD-HIES or Job's Syndrome), a rare and complex primary immunodeficiency (PID) syndrome characterized by increased levels of IgE (>2000 IU/mL), eosinophilia, recurrent staphylococcal skin abscesses, eczema, recurrent pneumonia, skeletal and connective tissue abnormalities. Although bacterial and fungal infections are common in AD-HIES, susceptibility to parasitic infections has not been reported. Alveolar echinococcosis (AE), a zoonosis caused by the growth of the Echinococcus multilocularis (EM) metacestode, mimics slow-growing liver cancer. The mortality rate of AE is very high when it is diagnosed late or under-treated. Here, we report a 14-year-old boy with AE infections of the liver and the lung resulting in liver failure and diagnosed as STAT3-LOF. To our knowledge, the association between these two conditions has not been reported in the literature before.

Keywords: Alveolar echinococcosis; Autosomal dominant hyper immunoglobulin E syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Animals
  • Echinococcosis / genetics*
  • Humans
  • Immunoglobulin E / genetics
  • Job Syndrome / genetics
  • Liver
  • Liver Neoplasms / genetics
  • Male
  • Mutation / genetics*
  • STAT3 Transcription Factor / genetics*

Substances

  • STAT3 Transcription Factor
  • STAT3 protein, human
  • Immunoglobulin E

Supplementary concepts

  • Alveolar echinococcosis