TY - JOUR
T1 - GATA2 deficiency
T2 - A protean disorder of hematopoiesis, lymphatics, and immunity
AU - Spinner, Michael A.
AU - Sanchez, Lauren A.
AU - Hsu, Amy P.
AU - Shaw, Pamela A.
AU - Zerbe, Christa S.
AU - Calvo, Katherine R.
AU - Arthur, Diane C.
AU - Gu, Wenjuan
AU - Gould, Christine M.
AU - Brewer, Carmen C.
AU - Cowen, Edward W.
AU - Freeman, Alexandra F.
AU - Olivier, Kenneth N.
AU - Uzel, Gulbu
AU - Zelazny, Adrian M.
AU - Daub, Janine R.
AU - Spalding, Christine D.
AU - Claypool, Reginald J.
AU - Giri, Neelam K.
AU - Alter, Blanche P.
AU - Mace, Emily M.
AU - Orange, Jordan S.
AU - Cuellar-Rodriguez, Jennifer
AU - Hickstein, Dennis D.
AU - Holland, Steven M.
PY - 2014/2/6
Y1 - 2014/2/6
N2 - Haploinsufficiency of the hematopoietic transcription factor GATA2 underlies monocytopenia andmycobacterial infections; dendritic cell,monocyte,B, and natural killer (NK) lymphoid deficiency; familial myelodysplastic syndromes (MDS)/acute myeloid leukemia (AML); and Emberger syndrome (primary lymphedema with MDS). A comprehensive examination of the clinical features ofGATA2 deficiency is currently lacking.We reviewed the medical records of 57 patients with GATA2 deficiency evaluated at the National Institutes of Health from January 1, 1992, to March 1, 2013, and categorized mutations as missense, null, or regulatory to identify genotype-phenotype associations. We identified a broad spectrum of disease: hematologic (MDS 84%, AML 14%, chronic myelomonocytic leukemia8%), infectious (severe viral 70%, disseminatedmycobacterial 53%, and invasive fungal infections 16%), pulmonary (diffusion 79%and ventilatory defects 63%, pulmonary alveolar proteinosis 18%, pulmonary arterial hypertension 9%), dermatologic (warts 53%, panniculitis 30%), neoplastic (human papillomavirus+ tumors 35%, Epstein-Barr virus+ tumors 4%), vascular/lymphatic (venous thrombosis 25%, lymphedema 11%), sensorineural hearing loss 76%, miscarriage 33%, and hypothyroidism 14%. Viral infections and lymphedemaweremore common in individualswith nullmutations (P = .038 and P = .006, respectively). Monocytopenia, B, NK, and CD4 lymphocytopenia correlated with the presence of disease (P <.001). GATA2 deficiency unites susceptibility to MDS/AML, immunodeficiency, pulmonary disease, and vascular/lymphatic dysfunction. Early genetic diagnosis is critical to direct clinical management, preventive care, and family screening.
AB - Haploinsufficiency of the hematopoietic transcription factor GATA2 underlies monocytopenia andmycobacterial infections; dendritic cell,monocyte,B, and natural killer (NK) lymphoid deficiency; familial myelodysplastic syndromes (MDS)/acute myeloid leukemia (AML); and Emberger syndrome (primary lymphedema with MDS). A comprehensive examination of the clinical features ofGATA2 deficiency is currently lacking.We reviewed the medical records of 57 patients with GATA2 deficiency evaluated at the National Institutes of Health from January 1, 1992, to March 1, 2013, and categorized mutations as missense, null, or regulatory to identify genotype-phenotype associations. We identified a broad spectrum of disease: hematologic (MDS 84%, AML 14%, chronic myelomonocytic leukemia8%), infectious (severe viral 70%, disseminatedmycobacterial 53%, and invasive fungal infections 16%), pulmonary (diffusion 79%and ventilatory defects 63%, pulmonary alveolar proteinosis 18%, pulmonary arterial hypertension 9%), dermatologic (warts 53%, panniculitis 30%), neoplastic (human papillomavirus+ tumors 35%, Epstein-Barr virus+ tumors 4%), vascular/lymphatic (venous thrombosis 25%, lymphedema 11%), sensorineural hearing loss 76%, miscarriage 33%, and hypothyroidism 14%. Viral infections and lymphedemaweremore common in individualswith nullmutations (P = .038 and P = .006, respectively). Monocytopenia, B, NK, and CD4 lymphocytopenia correlated with the presence of disease (P <.001). GATA2 deficiency unites susceptibility to MDS/AML, immunodeficiency, pulmonary disease, and vascular/lymphatic dysfunction. Early genetic diagnosis is critical to direct clinical management, preventive care, and family screening.
UR - http://www.scopus.com/inward/record.url?scp=84894095710&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894095710&partnerID=8YFLogxK
U2 - 10.1182/blood-2013-07-515528
DO - 10.1182/blood-2013-07-515528
M3 - Article
C2 - 24227816
AN - SCOPUS:84894095710
SN - 0006-4971
VL - 123
SP - 809
EP - 821
JO - Blood
JF - Blood
IS - 6
ER -