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Adenosine deaminase 2 deficiency
What is adenosine deaminase 2 deficiency?
Adenosine deaminase 2 (ADA2) deficiency is a disorder characterized by abnormal inflammation of various tissues, particularly the blood vessels (vasculitis). Signs and symptoms can begin anytime from early childhood to adulthood. The severity of the disorder also varies, even among affected individuals in the same family.
Inflammation is a normal immune system response to injury and foreign invaders (such as bacteria). However, the uncontrolled inflammation that occurs in ADA2 deficiency can damage many of the body's tissues and organs, including the skin, gastrointestinal system, kidneys, and nervous system. Depending on the severity and location of the inflammation, the disorder can cause disability or be life-threatening. Features that have been described in people with ADA2 deficiency include fevers that are intermittent, meaning they come and go; areas of net-like, mottled skin discoloration called livedo racemosa; an enlarged liver and spleen (hepatosplenomegaly); and recurrent strokes affecting structures deep in the brain that can start in the first few years of life. ADA2 deficiency causes mild immune system abnormalities in some individuals, but it is usually not associated with a significantly increased risk of bacterial and viral infections.
ADA2 deficiency is sometimes described as a form of polyarteritis nodosa (PAN), a disorder that causes inflammation of blood vessels throughout the body (systemic vasculitis). However, not all researchers classify ADA2 deficiency as a type of PAN.
How common is adenosine deaminase 2 deficiency?
Only a few dozen individuals with ADA2 deficiency have been described in the medical literature. However, researchers suspect that it may not be a rare disease. They are working to determine whether ADA2 deficiency could underlie other, more common forms of vasculitis and stroke whose causes are currently unknown.
What genes are related to adenosine deaminase 2 deficiency?
ADA2 deficiency is caused by mutations in the CECR1 gene. This gene provides instructions for making an enzyme called adenosine deaminase 2. Studies suggest that this enzyme plays an essential role in keeping the lining of blood vessel walls intact. It also appears to be involved in the growth and development of certain immune system cells, including macrophages, which are a type of white blood cell that plays a critical role in inflammation. Some macrophages are pro-inflammatory, meaning they promote inflammation, while others are anti-inflammatory, meaning they reduce inflammation.
Mutations in the CECR1 gene severely reduce or eliminate the function of adenosine deaminase 2. Researchers do not fully understand how a loss of this enzyme's function leads to the features of ADA2 deficiency. They speculate that a lack of this enzyme may disrupt the balance between pro-inflammatory and anti-inflammatory macrophages in various tissues, leading to abnormal inflammation. The enzyme's role in maintaining the structural integrity of blood vessels could help explain why the blood vessels are most often affected by inflammation in this disorder.
Read more about the CECR1 gene.
How do people inherit adenosine deaminase 2 deficiency?
This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.
Where can I find information about diagnosis or management of adenosine deaminase 2 deficiency?
These resources address the diagnosis or management of adenosine deaminase 2 deficiency and may include treatment providers.
You might also find information on the diagnosis or management of adenosine deaminase 2 deficiency in Educational resources and Patient support.
General information about the diagnosis and management of genetic conditions is available in the Handbook. Read more about genetic testing, particularly the difference between clinical tests and research tests.
To locate a healthcare provider, see How can I find a genetics professional in my area? in the Handbook.
Where can I find additional information about adenosine deaminase 2 deficiency?
You may find the following resources about adenosine deaminase 2 deficiency helpful. These materials are written for the general public.
- MedlinePlus - Health information (3 links)
- Genetic and Rare Diseases Information
Center- Information about genetic conditions and rare diseases
- Additional NIH Resources - National Institutes of Health (2 links)
- Educational resources - Information pages (4 links)
- Patient support - For patients and families (5 links)
You may also be interested in these resources, which are designed for healthcare professionals and researchers.
- Genetic Testing Registry - Repository of genetic test information (1 link)
PubMed- Recent literature OMIM- Genetic disorder catalog
What other names do people use for adenosine deaminase 2 deficiency?
- ADA2 deficiency
- childhood-onset polyarteritis nodosa
- deficiency of ADA2
- Sneddon syndrome
For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines and How are genetic conditions and genes named? in the Handbook.
What if I still have specific questions about adenosine deaminase 2 deficiency?
Where can I find general information about genetic conditions?
The Handbook provides basic information about genetics in clear language.
- What does it mean if a disorder seems to run in my family?
- What are the different ways in which a genetic condition can be inherited?
- If a genetic disorder runs in my family, what are the chances that my children will have the condition?
- Why are some genetic conditions more common in particular ethnic groups?
These links provide additional genetics resources that may be useful.
What glossary definitions help with understanding adenosine deaminase 2 deficiency?
autosomal ; autosomal recessive ; bacteria ; cell ; deficiency ; disability ; enzyme ; gastrointestinal ;gene ; hepatosplenomegaly ; immune system ; inflammation ; inherited ; injury ; nervous system ;neutrophils ; Pro ; recessive ; syndrome
You may find definitions for these and many other terms in the Genetics Home Reference Glossary.
See also Understanding Medical Terminology.
References (7 links)
The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? in the Handbook.
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