Clinical Working Party
X-Linked Lymphoproliferative Syndrome
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Definitive
Male patient with lymphoma/ Hodgkins disease, fatal EBV infection, immunodeficiency, aplastic anemia or lymphohistiocytic disorder who has a mutation in SH2D1A/SAP/DSHP.
Probable
Male patient experiencing death, lymphoma/Hodgkins disease, immunodeficiency, aplastic anemia or lymphohistiocytic disorder following acute EBV infection and maternal cousins, uncles or nephews with a history of similar diagnoses following acute EBV infection.
Possible
Male patient experiencing death, lymphoma/Hodgkin's disease, immunodeficiency, aplastic anemia or lymphohistiocytic disorder following acute EBV infection.
Spectrum of disease
Males with XLP are usually asymptomatic until they develop EBV infection, which may cause fulminant hepatitis (60% of all patients), particularly in young children.
Hodgkin or non-Hodgkin lymphoma (30%), and/or immune deficiency with low serum IgG and abnormal NK cell function (30%) are more likely to develop in older patients. Less common manifestations include EBV-associated hemophagocytic syndrome and vasculitis. The vast majority of patients die in childhood; survival rate is very poor for males with fulminant hepatitis (<5%), and higher for those with isolated dysgammaglobulinemia (50%).