Incidental diagnosis of leukocyte adhesion deficiency type II following ABO typing

Clin Immunol. 2020 Dec:221:108599. doi: 10.1016/j.clim.2020.108599. Epub 2020 Sep 28.

Abstract

Individuals with the Bombay phenotype (Oh) in the ABO blood group system do not express the H, A, and B antigens but have no clinical symptoms. Bombay phenotype with clinical symptoms has been described in leukocyte adhesion deficiency type II (LAD II), a fucosylation disorder caused by mutations in SLC35C1. Only few LAD II patients have been described so far. Here we describe an additional patient, a 22-year old male, born to unrelated parents, presenting with inflammatory skin disease, periodontitis, growth, and mental retardation, admitted to the department of dentistry for treatment under general anesthesia. Pre-operative routine investigations revealed the presence of the Bombay phenotype (Oh). Genomic sequencing identified two novel triplet deletions of the SLC35C1 gene. Functional investigations confirmed the diagnosis of LAD II. Therapy with oral fucose led to the disappearance of the chronic skin infections and improvements in behavior and attention span.

Keywords: Bombay phenotype; Congenital disorder of glycosylation; Fucose; Leukocyte adhesion deficiency type II; Periodontitis; SLC35C1.

Publication types

  • Case Reports

MeSH terms

  • ABO Blood-Group System
  • Adult
  • Blood Grouping and Crossmatching
  • Erythrocytes
  • Fucose / therapeutic use
  • Humans
  • Leukocyte-Adhesion Deficiency Syndrome / blood
  • Leukocyte-Adhesion Deficiency Syndrome / diagnosis*
  • Leukocyte-Adhesion Deficiency Syndrome / drug therapy
  • Leukocyte-Adhesion Deficiency Syndrome / genetics
  • Leukocytes
  • Male
  • Monosaccharide Transport Proteins / genetics
  • Young Adult

Substances

  • ABO Blood-Group System
  • Monosaccharide Transport Proteins
  • SLC35C1 protein, human
  • Fucose