Abstract
X-linked agammagobulinemia (XLA) is a primary immunodeficiency disorder
caused by a mutation in the Bruton Tyrosine Kinase (BTK). Usually,
patients present severe infections before the age of 2, and require
immunoglobulin replacement therapy during all their life. We present the
case of a 16-years-old male for whom the diagnosis was incidental. He
did not present any infection since childhood. At the age of 4,
immunoglobulin assay was performed because he had recurrent fever
episodes. A panhypogammaglobulinemia was identified, but the boy became
asymptomatic and explorations were stopped. At the age of 16, the
patient’s parents suggested a control of the deficit which was
confirmed. Genetic testing revealed a novel mutation on BTK, located in
the pleckstrin homology domain [c.70A>C, p.(Asn24His)].
Initially, he received immunoglobulin substitution at the rate of one
subcutaneous injection per week but stopped it after 2 years of
treatment by immunoglobulin and continued to present no symptom. We
thereafter report the case of an asymptomatic patient presenting a novel
missense mutation of BTK. The patient doesn’t have circulant B cell. He
doesn’t receive immunoglobulin substitution and doesn’t present
infectious diseases.