Myeloperoxidase deficiency and other enzymatic WBC defects causing immunodeficiency
- Sergio D Rosenzweig, MD
Sergio D Rosenzweig, MD
- Department of Laboratory Medicine
- Steven M Holland, MD
Steven M Holland, MD
- Laboratory of Clinical Infectious Diseases
- National Institutes of Health, Bethesda, MD
There are a small number of well-described genetic defects in hematopoietic cell enzymes or transporter proteins that can result in neutrophil dysfunction and immunodeficiency. Two of these, myeloperoxidase (MPO) deficiency and glucose-6-phosphate dehydrogenase (G6PD) deficiency, are relatively common. The others presented in this review, glutathione reductase (GR) deficiency, glutathione synthetase (GS) deficiency, and glycogen storage disease type 1b (GSD1b), are rare.
This topic review provides an overview of the genetic defects responsible for each of these disorders as well as their clinical manifestations, diagnosis, and treatment. The focus of this review, however, is the mechanism of neutrophil or leukocyte dysfunction in each condition that leads to immunodeficiency.
Some of these conditions are discussed in other contexts elsewhere. (See "Genetics and pathophysiology of glucose-6-phosphate dehydrogenase deficiency" and "Diagnosis and management of glucose-6-phosphate dehydrogenase deficiency" and "Glucose-6-phosphatase deficiency (glycogen storage disease I, von Gierke disease)" and "Congenital neutropenia".)
Myeloperoxidase (MPO) deficiency (MIM# 254600) is an autosomal recessive inherited disorder, with a variable clinical phenotype. It is also the most common primary phagocyte disorder [1-4]:
●1 in 4000 individuals have complete MPO deficiency
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- MYELOPEROXIDASE DEFICIENCY
- Biology of myeloperoxidase
- Clinical manifestations
- - Candida infections
- - Noninfectious diseases
- GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY
- Clinical manifestations
- Evaluation and diagnosis
- GLUTATHIONE PATHWAY ALTERATIONS
- Clinical manifestations
- - GS deficiency
- - GR deficiency
- GLYCOGEN STORAGE DISEASE 1b
- Clinical manifestations
- Evaluation and diagnosis