GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases

Abstract Purpose GATA2 deficiency is an autosomal dominant disease that manifests with a range of clinical symptoms, including increased susceptibility to viral, bacterial, and fungal infections. Furthermore, the increased susceptibility to infections in GATA2 deficiency can trigger hemophagocytic l...

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Main Authors: Mohammad Rezaei Zadeh Rukerd, Hanieh Mirkamali, Mohsen Nakhaie, Seyed Danial Alizadeh
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10145-1
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author Mohammad Rezaei Zadeh Rukerd
Hanieh Mirkamali
Mohsen Nakhaie
Seyed Danial Alizadeh
author_facet Mohammad Rezaei Zadeh Rukerd
Hanieh Mirkamali
Mohsen Nakhaie
Seyed Danial Alizadeh
author_sort Mohammad Rezaei Zadeh Rukerd
collection DOAJ
description Abstract Purpose GATA2 deficiency is an autosomal dominant disease that manifests with a range of clinical symptoms, including increased susceptibility to viral, bacterial, and fungal infections. Furthermore, the increased susceptibility to infections in GATA2 deficiency can trigger hemophagocytic lymphohistiocytosis (HLH) in these patients. Our systematic review evaluates reported cases of GATA2 deficiency and HLH in the literature. Methods A systematic review of case reports was conducted following PRISMA 2020 guidelines, encompassing studies retrieved from Ovid MEDLINE ALL, Embase via Ovid SP, Scopus, Web of Science, and Google Scholar from inception until June 14, 2024. This review included studies reporting patients diagnosed with GATA2 deficiency or having a documented history of the condition, who subsequently developed or were concurrently diagnosed with HLH. Various study types were considered, such as case reports, case series, letters to editors, original articles, correspondences, and commentaries, without any restrictions on language. Results In our systematic review, 15 studies from 2016 to 2024 were analyzed, encompassing 23 patients with GATA2 deficiency and HLH. the mean (SD) age of patients was 23.48 (10.54) years, ranging from 7 to 57 years. These patients exhibited diverse genetic mutations and a spectrum of infections, particularly Mycobacterium avium (M. avium), Mycobacterium kansasii (M. kansasii), Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and influenza A, often leading to HLH. Family histories of GATA2-deficient patients with HLH occasionally reveal confirmed GATA2 mutations or suspicious cases among first-degree relatives. Hematopoietic stem cell transplantation (HSCT) was performed in 8 patients with GATA2 deficiency and HLH. Among them, 6 patients survived post-therapy, while 2 patients died following HSCT. Currently, 1 patient is being considered for HSCT. The overall mortality rate among GATA2 deficiency patients who experienced HLH was 39.13%. Conclusions This systematic review highlights GATA2 deficiency’s association with diverse infections triggering HLH, emphasizing early infection management to mitigate mortality risks. This comprehensive analysis contributes to scientific knowledge, offering important insights for clinicians and researchers in diagnosing and managing this rare condition.
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spelling doaj-art-308697ad562041f78629fbacd2443db82024-11-10T12:09:59ZengBMCBMC Infectious Diseases1471-23342024-11-0124112110.1186/s12879-024-10145-1GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported casesMohammad Rezaei Zadeh Rukerd0Hanieh Mirkamali1Mohsen Nakhaie2Seyed Danial Alizadeh3Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical SciencesFaculty of Medicine, Kerman University of Medical SciencesGastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical SciencesSina Trauma and Surgery Research Center, Kerman University of Medical SciencesAbstract Purpose GATA2 deficiency is an autosomal dominant disease that manifests with a range of clinical symptoms, including increased susceptibility to viral, bacterial, and fungal infections. Furthermore, the increased susceptibility to infections in GATA2 deficiency can trigger hemophagocytic lymphohistiocytosis (HLH) in these patients. Our systematic review evaluates reported cases of GATA2 deficiency and HLH in the literature. Methods A systematic review of case reports was conducted following PRISMA 2020 guidelines, encompassing studies retrieved from Ovid MEDLINE ALL, Embase via Ovid SP, Scopus, Web of Science, and Google Scholar from inception until June 14, 2024. This review included studies reporting patients diagnosed with GATA2 deficiency or having a documented history of the condition, who subsequently developed or were concurrently diagnosed with HLH. Various study types were considered, such as case reports, case series, letters to editors, original articles, correspondences, and commentaries, without any restrictions on language. Results In our systematic review, 15 studies from 2016 to 2024 were analyzed, encompassing 23 patients with GATA2 deficiency and HLH. the mean (SD) age of patients was 23.48 (10.54) years, ranging from 7 to 57 years. These patients exhibited diverse genetic mutations and a spectrum of infections, particularly Mycobacterium avium (M. avium), Mycobacterium kansasii (M. kansasii), Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and influenza A, often leading to HLH. Family histories of GATA2-deficient patients with HLH occasionally reveal confirmed GATA2 mutations or suspicious cases among first-degree relatives. Hematopoietic stem cell transplantation (HSCT) was performed in 8 patients with GATA2 deficiency and HLH. Among them, 6 patients survived post-therapy, while 2 patients died following HSCT. Currently, 1 patient is being considered for HSCT. The overall mortality rate among GATA2 deficiency patients who experienced HLH was 39.13%. Conclusions This systematic review highlights GATA2 deficiency’s association with diverse infections triggering HLH, emphasizing early infection management to mitigate mortality risks. This comprehensive analysis contributes to scientific knowledge, offering important insights for clinicians and researchers in diagnosing and managing this rare condition.https://doi.org/10.1186/s12879-024-10145-1GATA2 deficiencyHemophagocytic lymphohistiocytosisHLHNK-cell
spellingShingle Mohammad Rezaei Zadeh Rukerd
Hanieh Mirkamali
Mohsen Nakhaie
Seyed Danial Alizadeh
GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
BMC Infectious Diseases
GATA2 deficiency
Hemophagocytic lymphohistiocytosis
HLH
NK-cell
title GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
title_full GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
title_fullStr GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
title_full_unstemmed GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
title_short GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases
title_sort gata2 deficiency and hemophagocytic lymphohistiocytosis hlh a systematic review of reported cases
topic GATA2 deficiency
Hemophagocytic lymphohistiocytosis
HLH
NK-cell
url https://doi.org/10.1186/s12879-024-10145-1
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