Compound heterozygous LPIN2 pathogenic variants in a patient with Majeed syndrome with recurrent fever and severe neutropenia: case report

BMC Med Genet. 2019 Nov 14;20(1):182. doi: 10.1186/s12881-019-0919-3.

Abstract

Background: Majeed syndrome is a rare, autosomal recessive autoinflammatory disorder first described in 1989. The syndrome starts during infancy with recurrent relapses of osteomyelitis typically associated with fever, congenital dyserythropoietic anemia (CDA), and often neutrophilic dermatosis. Mutations in the LPIN2 gene located on the short arm of chromosome 18 have been identified as being responsible for Majeed syndrome.

Case presentation: We report an 8-month-old boy, who presented with recurrent fever, mild to moderate anemia, and severe neutropenia. Erythrocyte sedimentation rate and C-reactive protein were elevated. Molecular testing identified a paternal splicing donor site variant c.2327 + 1G > C and a maternal frameshift variant c.1691_1694delGAGA (Arg564Lysfs*3) in LPIN2.

Conclusions: Only a few cases with LPIN2 mutation have been reported, mainly in the Middle East with homozygous variants. Our patient exhibited a mild clinical phenotype and severe neutropenia, different from previous reports.

Keywords: Autosomal recessive; Fever; Majeed syndrome; Neutropenia.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Dyserythropoietic, Congenital / complications
  • Anemia, Dyserythropoietic, Congenital / genetics*
  • Female
  • Fever / complications*
  • Humans
  • Immunologic Deficiency Syndromes / complications
  • Immunologic Deficiency Syndromes / genetics*
  • Infant
  • Male
  • Mutation*
  • Neutropenia / complications*
  • Nuclear Proteins / genetics*
  • Osteomyelitis / complications
  • Osteomyelitis / genetics*
  • Pedigree
  • Recurrence
  • Severity of Illness Index

Substances

  • LPIN2 protein, human
  • Nuclear Proteins

Supplementary concepts

  • Majeed syndrome