Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Complete recovery from Cryptosporidium parvum infection with gastroenteritis and sclerosing cholangitis after successful bone marrow transplantation in two brothers with X-linked hyper-IgM syndrome

Summary:

We describe two brothers who suffered from hyper-IgM syndrome (HIGM1) with similar clinical features: recurrent infections, especially cryptosporidium gastroenteritis with cholangitis. Their activated T cells did not express CD40L. Nucleotide sequencing revealed a mutation in both boys with respect to intron 4 and exon 5 boundaries of the CD40L gene in Xq26. They underwent successful bone marrow transplantation (BMT) from HLA-geno-identical siblings. The Cryptosporidium infection and cholangitis resolved thereafter. At 6 months after BMT, expression of CD40L on activated T lymphocytes was normal. After 1 year, both boys are well, and immune reconstitution has improved. Based on these two successful experiences, BMT with a genoidentical sibling seems a reasonable therapeutic approach for HIGM1, if Cryptosporidium infection occurs.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

Benedetta Terziroli Beretta-Piccoli, Giorgina Mieli-Vergani & Diego Vergani

References

  1. Puck JM . A disease gene for autosomal hyper-IgM syndrome: more genes associated with more immunodeficiencies. Clin Immunol 2000; 97: 191–192.

    Article  CAS  Google Scholar 

  2. Fuleihan RL . Hyper IgM syndrome: the other side of the coin. Curr Opin Pediatr 2001; 13: 528–532.

    Article  CAS  Google Scholar 

  3. Fries KM, Sempowski GD, Gaspari AA et al. CD40 expression by human fibroblasts. Clin Immunol Immunopathol 1995; 77: 42–51.

    Article  CAS  Google Scholar 

  4. Hayward AR, Levy J, Facchetti F et al. Cholangiopathy and tumors of the pancreas, liver, and biliary tree in boys with X-linked immunodeficiency with hyper-IgM. J Immunol 1997; 158: 977–983.

    CAS  Google Scholar 

  5. Hayward AR, Cosyns M, Jones M, Ponnuraj EM . Marrow-derived CD40-positive cells are required for mice to clear Cryptosporidium parvum infection. Infect Immun 2000; 69: 1630–1634.

    Article  Google Scholar 

  6. Thomas C, De Saint Basile G, Le Deist F et al. Brief report: correction of X-linked hyper-IgM syndrome by allogeneic bone marrow transplantation. N Engl J Med 1995; 333: 126–129.

    Article  Google Scholar 

  7. Bordigoni P, Auburtin B, Carret AS et al. Bone marrow transplantation as treatment for X-linked immunodeficiency with hyper-IgM. Bone Marrow Transplant 1998; 22: 1111–1114.

    Article  CAS  Google Scholar 

  8. Amrolia P, Gaspar H, Hassan A et al. Nonmyeloablative stem cell transplantation for congenital immunodeficiencies. Blood 2000; 96: 1239–1246.

    CAS  Google Scholar 

  9. Khawaja K, Gennery AR, Flood TJ et al. Bone marrow transplantation for CD40 ligand deficiency: a single centre experience. Arch Dis Child 2001; 84: 508–511.

    Article  CAS  Google Scholar 

  10. Wu Z, Nagano I, Matsuo A, Uga S et al . Specific PCR primers for Cryptosporidium parvum with extra high sensitivity. Mol Cell Probes 2000; 14: 33–39.

    Article  CAS  Google Scholar 

  11. Hadzic N, Pagliuca A, Rela M et al. Correction of the hyper-IgM syndrome after liver and bone marrow transplantation. N Engl J Med 2000; 342: 320–324.

    Article  CAS  Google Scholar 

  12. Martinez Ibanez V, Espanol T, Matamoros N et al. Relapse of sclerosing cholangitis after liver transplant in patients with hyper-IgM syndrome. Transplant Proc 1997; 29: 432–433.

    Article  CAS  Google Scholar 

  13. Levy J, Espanol-Boren T, Thomas C et al . Clinical spectrum of X-linked hyper-IgM syndrome. J Pediatr 1997; 131: 47–54.

    Article  CAS  Google Scholar 

  14. Vestereng VH, Kovacs JA . Recombinant CD40 ligand administration does not decrease intensity of Pneumocystis carinii infection in SCID mice. J Eucaryot Microbiol 2001: (Suppl.): 153S–154S.

Download references

Acknowledgements

We thank Mrs D Binot Saintot and S Lapuyade for their excellent technical assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D Bensoussan.

Additional information

The first two authors contributed equally to this work

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dimicoli, S., Bensoussan, D., Latger-Cannard, V. et al. Complete recovery from Cryptosporidium parvum infection with gastroenteritis and sclerosing cholangitis after successful bone marrow transplantation in two brothers with X-linked hyper-IgM syndrome. Bone Marrow Transplant 32, 733–737 (2003). https://doi.org/10.1038/sj.bmt.1704211

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704211

Keywords

This article is cited by

Search

Quick links