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RASGRP1 Deficiency Manifesting as Severe Vasculopathy and Fatal Autoimmune Hemolytic Anemia
Kosar Asna Ashari1,2,3,4, Bahareh Yaghmaie5, Neda Pak2
1Department of Pediatrics Tehran University of Medical Sciences Tehran Iran.
Ejhaem
|June 8, 2026
Summary
RASGRP1 deficiency, a rare inborn error of immunity, can cause severe vasculopathy and autoimmune complications. Early genetic diagnosis and hematopoietic stem cell transplantation are crucial for managing this condition.
Area of Science:
- Immunology
- Genetics
- Pediatrics
Background:
- RASGRP1 deficiency is a rare inborn error of immunity.
- It is characterized by immunodeficiency, autoimmunity, and lymphoproliferation.
Purpose of the Study:
- To report a novel case of RASGRP1 deficiency.
- To highlight the emerging phenotype of vascular autoimmunity.
Main Methods:
- Case report of a 5-year-old male.
- Genetic analysis identifying novel homozygous splice-donor mutations in RASGRP1.
- Review of 14 previously reported cases and the current case.
Main Results:
- The patient presented with severe vasculopathy, including ischemic stroke and thrombosis.
- Secondary antiphospholipid syndrome and fatal refractory autoimmune hemolytic anemia were observed.
- Infections (100%) and lymphoproliferation (87%) are common in RASGRP1 deficiency.
Conclusions:
- Vascular autoimmunity is an emerging, life-threatening phenotype in RASGRP1 deficiency.
- Hematopoietic stem cell transplantation is the only curative therapy.
- Early genetic diagnosis is essential for optimal management.
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