학술논문

Testicular ischemia in deficiency of adenosine deaminase 2 (DADA2)
Document Type
article
Source
Pediatric Rheumatology Online Journal, Vol 17, Iss 1, Pp 1-7 (2019)
Subject
Deficiency of adenosine deaminase 2
DADA2
Testicular infarction
Vasculitis
Anti-tumour necrosis factor alpha
Aspirin
Pediatrics
RJ1-570
Diseases of the musculoskeletal system
RC925-935
Language
English
ISSN
1546-0096
Abstract
Abstract Background Deficiency of adenosine deaminase 2 (DADA2) is a rare autosomal recessive autoinflammatory condition. Recognised features include vasculitis predominantly affecting medium sized vessels, livedoid skin rash, central and peripheral nervous system involvement, variable degrees of immunodeficiency, and marrow failure, amongst other clinical presentations. We present the case of a six year old male with DADA2 who presented with acute testicular ischaemia secondary to vasculitis, the first such description in DADA2. Case presentation A six year old male presented acute right-sided testicular pain. His history included transient infantile neutropenia, resolved hepatosplenomegaly, and longstanding livedo racemosa, leading to screening and confirmation of DADA2 caused by homozygous c.139G > C (p.G47R) mutation of ADA2. As his only clinical feature was that of mild livedo racemosa with normal laboratory parameters at diagnosis, he was being actively monitored prior to starting any treatment. At a routine clinic follow-up a 24 h history of testicular pain was noted on systems review. He was afebrile, and his only physical signs were that of moderate livedo racemosa, and tenderness of the right testicle. Laboratory parameters revealed C-reactive protein (CRP) 8 mg/L (reference range [RR]