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T-lymphocyte deficiency(TIDTA)

MedGen UID:
101814
Concept ID:
C0152094
Disease or Syndrome
Synonyms: Immune defect due to absence of thymus; Nezelof syndrome; Thymic aplasia
SNOMED CT: Nezelof syndrome (55602000); Nezelof's syndrome (55602000); Congenital thymic dysplasia syndrome (55602000)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
X-linked recessive inheritance
MedGen UID:
375779
Concept ID:
C1845977
Finding
Source: Orphanet
A mode of inheritance that is observed for recessive traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked recessive disorders manifest in males (who have one copy of the X chromosome and are thus hemizygotes), but generally not in female heterozygotes who have one mutant and one normal allele.
 
Monarch Initiative: MONDO:0009451
OMIM®: 242700
Orphanet: ORPHA83471

Definition

T-cell immunodeficiency with thymic aplasia (TIDTA) is an autosomal recessive disorder that is often detected at birth through newborn SCID screening with the finding of decreased T-cell receptor excision circles (TRECs). Affected individuals have selective hypo- or aplasia of the thymus, which results in T-cell immunodeficiency due to impaired T-cell development and increased susceptibility to viral infections. The phenotype is similar to T-/B+/NK+ SCID. Some patients may die in childhood; thymus transplantation may be curative (summary by Du et al., 2019). [from OMIM]

Clinical features

From HPO
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Hepatosplenomegaly
MedGen UID:
9225
Concept ID:
C0019214
Sign or Symptom
Simultaneous enlargement of the liver and spleen.
Chronic diarrhea
MedGen UID:
96036
Concept ID:
C0401151
Finding
The presence of chronic diarrhea, which is usually taken to mean diarrhea that has persisted for over 4 weeks.
Bronchiectasis
MedGen UID:
14234
Concept ID:
C0006267
Disease or Syndrome
Persistent abnormal dilatation of the bronchi owing to localized and irreversible destruction and widening of the large airways.
Emphysema
MedGen UID:
18764
Concept ID:
C0034067
Disease or Syndrome
A subcategory of chronic obstructive pulmonary disease (COPD). It occurs in people who smoke and suffer from chronic bronchitis. It is characterized by inflation of the alveoli, alveolar wall damage, and reduction in the number of alveoli, resulting in difficulty breathing.
Recurrent pneumonia
MedGen UID:
195802
Concept ID:
C0694550
Disease or Syndrome
An increased susceptibility to pneumonia as manifested by a history of recurrent episodes of pneumonia.
Recurrent bronchopulmonary infections
MedGen UID:
488990
Concept ID:
C2169795
Finding
An increased susceptibility to bronchopulmonary infections as manifested by a history of recurrent bronchopulmonary infections.
Eczematoid dermatitis
MedGen UID:
3968
Concept ID:
C0013595
Disease or Syndrome
Eczema is a form of dermatitis that is characterized by scaly, pruritic, erythematous lesions located on flexural surfaces.
Lymphopenia
MedGen UID:
7418
Concept ID:
C0024312
Disease or Syndrome
A reduced number of lymphocytes in the blood.
Pyoderma
MedGen UID:
18783
Concept ID:
C0034212
Disease or Syndrome
Any manifestation of a skin disease associated with the production of pus.
Aplasia of the thymus
MedGen UID:
146900
Concept ID:
C0685894
Congenital Abnormality
Absence of the thymus. This feature may be appreciated by the lack of a thymic shadow upon radiographic examination.
Recurrent viral infections
MedGen UID:
332357
Concept ID:
C1837066
Finding
Increased susceptibility to viral infections, as manifested by recurrent episodes of viral infection.
Reduced delayed hypersensitivity
MedGen UID:
334744
Concept ID:
C1843386
Finding
Decreased ability to react to a delayed hypersensitivity skin test.
T lymphocytopenia
MedGen UID:
419385
Concept ID:
C2931322
Finding
An abnormally low count of T cells.
Abnormally low T cell receptor excision circle level
MedGen UID:
1611921
Concept ID:
C4531052
Finding
Reduced level of T cell receptor excision circle (TRECs) as measured by the TREC assay. Late in maturation, 70% of thymocytes that will ultimately express alpha/beta-T cell receptors form a circular DNA TREC from the excised TCRdelta gene that lies within the TCRalpha genetic locus. The circles are stable but do not increase following cell division and, therefore, become diluted as T cells proliferate. A quantitative polymerase chain reaction (PCR) reaction across the joint of the circular DNA provides the TREC copy number, a marker of newly-formed, antigenically-naïve thymic emigrant T cells.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • T-lymphocyte deficiency

Professional guidelines

Recent clinical studies

Etiology

Kolenko YG, Timokhina TO, Lynovytska OV, Cherkasova OV, Pechkovskyi KE
Wiad Lek 2023;76(5 pt 2):1309-1315. doi: 10.36740/WLek202305227. PMID: 37364090
Du Y, Li X, Yu H, Yan L, Lau WB, Zhang S, Qin Y, Wang W, Ma X, Liu H, Fu M
Cardiovasc Drugs Ther 2019 Apr;33(2):149-161. doi: 10.1007/s10557-019-06856-2. PMID: 30747396
Gabra N, Alromaih S, Endam LM, Brito RM, Larivière F, Al-Mot S, LeDeist F, Desrosiers M
Int Forum Allergy Rhinol 2014 Jun;4(6):495-501. Epub 2014 Mar 17 doi: 10.1002/alr.21313. PMID: 24639246
Macedo C, Walters JT, Orkis EA, Isse K, Elinoff BD, Fedorek SP, McMichael JM, Chalasani G, Randhawa P, Demetris AJ, Zeevi A, Tan H, Shapiro R, Landsittel D, Lakkis FG, Metes D
Transplantation 2012 Apr 27;93(8):813-21. doi: 10.1097/TP.0b013e318247a717. PMID: 22343334Free PMC Article
Kusters MA, Gemen EF, Verstegen RH, Wever PC, DE Vries E
Pediatr Res 2010 May;67(5):557-62. doi: 10.1203/PDR.0b013e3181d4eca3. PMID: 20098345

Diagnosis

Pavlovic AM, Bonaci-Nikolic B, Kozic D, Ostojic J, Abinun M, Svabic-Medjedovic T, Nikolic M, Sternic N
Lupus 2012 Jan;21(1):100-2. Epub 2011 Oct 5 doi: 10.1177/0961203311416693. PMID: 21976399
McGuire JL, Fridman V, Wüthrich C, Koralnik IJ, Jacobs D
J Neurovirol 2011 Oct;17(5):500-3. Epub 2011 Jul 23 doi: 10.1007/s13365-011-0045-2. PMID: 21786075Free PMC Article
Hendriks RW, De Weers M, Mensink RG, Kraakman ME, Mollee-Versteegde IF, Veerman AJ, Sandkuyl LA, Schuurman RK
Clin Exp Immunol 1991 May;84(2):219-22. PMID: 1709069Free PMC Article
Zola H, Valdimarsson H
Br J Haematol 1978 Aug;39(4):607-14. doi: 10.1111/j.1365-2141.1978.tb03631.x. PMID: 308814
Valdimarsson H, McGuire RL
Clin Exp Immunol 1977 Aug;29(2):261-5. PMID: 302769Free PMC Article

Therapy

Gabra N, Alromaih S, Endam LM, Brito RM, Larivière F, Al-Mot S, LeDeist F, Desrosiers M
Int Forum Allergy Rhinol 2014 Jun;4(6):495-501. Epub 2014 Mar 17 doi: 10.1002/alr.21313. PMID: 24639246
Macedo C, Walters JT, Orkis EA, Isse K, Elinoff BD, Fedorek SP, McMichael JM, Chalasani G, Randhawa P, Demetris AJ, Zeevi A, Tan H, Shapiro R, Landsittel D, Lakkis FG, Metes D
Transplantation 2012 Apr 27;93(8):813-21. doi: 10.1097/TP.0b013e318247a717. PMID: 22343334Free PMC Article
Pavlovic AM, Bonaci-Nikolic B, Kozic D, Ostojic J, Abinun M, Svabic-Medjedovic T, Nikolic M, Sternic N
Lupus 2012 Jan;21(1):100-2. Epub 2011 Oct 5 doi: 10.1177/0961203311416693. PMID: 21976399
McGuire JL, Fridman V, Wüthrich C, Koralnik IJ, Jacobs D
J Neurovirol 2011 Oct;17(5):500-3. Epub 2011 Jul 23 doi: 10.1007/s13365-011-0045-2. PMID: 21786075Free PMC Article
Moen RC, Horowitz SD, Sondel PM, Borcherding WR, Trigg ME, Billing R, Hong R
Blood 1987 Sep;70(3):664-9. PMID: 3304460

Prognosis

Kolenko YG, Timokhina TO, Lynovytska OV, Cherkasova OV, Pechkovskyi KE
Wiad Lek 2023;76(5 pt 2):1309-1315. doi: 10.36740/WLek202305227. PMID: 37364090
Macedo C, Walters JT, Orkis EA, Isse K, Elinoff BD, Fedorek SP, McMichael JM, Chalasani G, Randhawa P, Demetris AJ, Zeevi A, Tan H, Shapiro R, Landsittel D, Lakkis FG, Metes D
Transplantation 2012 Apr 27;93(8):813-21. doi: 10.1097/TP.0b013e318247a717. PMID: 22343334Free PMC Article
Pavlovic AM, Bonaci-Nikolic B, Kozic D, Ostojic J, Abinun M, Svabic-Medjedovic T, Nikolic M, Sternic N
Lupus 2012 Jan;21(1):100-2. Epub 2011 Oct 5 doi: 10.1177/0961203311416693. PMID: 21976399
McGuire JL, Fridman V, Wüthrich C, Koralnik IJ, Jacobs D
J Neurovirol 2011 Oct;17(5):500-3. Epub 2011 Jul 23 doi: 10.1007/s13365-011-0045-2. PMID: 21786075Free PMC Article
Sidorov IA, Romanyukha AA
Math Biosci 1993 Jun;115(2):187-232. doi: 10.1016/0025-5564(93)90071-h. PMID: 8507990

Clinical prediction guides

Macedo C, Walters JT, Orkis EA, Isse K, Elinoff BD, Fedorek SP, McMichael JM, Chalasani G, Randhawa P, Demetris AJ, Zeevi A, Tan H, Shapiro R, Landsittel D, Lakkis FG, Metes D
Transplantation 2012 Apr 27;93(8):813-21. doi: 10.1097/TP.0b013e318247a717. PMID: 22343334Free PMC Article
Pérez-Aciego P, Alarcón B, Arnaiz-Villena A, Terhorst C, Timón M, Segurado OG, Regueiro JR
J Exp Med 1991 Aug 1;174(2):319-26. doi: 10.1084/jem.174.2.319. PMID: 1713248Free PMC Article
Kesarwala HH, Prasad RV, Szep R, Oldman E, Lane S, Papageorgiou PS
Clin Exp Immunol 1979 Jun;36(3):465-72. PMID: 487648Free PMC Article
Graham SD Jr, mickey DD, Paulson DF
J Natl Cancer Inst 1978 Mar;60(3):715-6. doi: 10.1093/jnci/60.3.715. PMID: 304899
Valdimarsson H, Hambleton G, Henry K, McConnell I
Clin Exp Immunol 1974 Feb;16(2):141-52. PMID: 4549704Free PMC Article

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