MonoMac syndrome with associated neurological deficits and longitudinally extensive cord lesion

Mastura Monif, Aamira Huq, Lynette Chee, Trevor Kilpatrick

Research output: Contribution to journalArticleOtherpeer-review

Abstract

We present a case of monocytopaenia and mycobacteria-related infection (MonoMac) syndrome in a 30-year-old man of Indian origin. The clinical diagnosis of GATA2 haploinsufficiency was suspected after an unusual neurological presentation on a background of myelodysplastic syndrome and childhood pulmonary tuberculosis. The patient had a longitudinally extensive spinal cord lesion and a lesion in the medulla. No obvious infective cause for the spinal cord MRI abnormality was found, and the lesions were presumed to be inflammatory in nature. The family history consisted of autosomal dominant clinical features suggestive of GATA2 haploinsufficiency. Genetic testing in peripheral leucocytes revealed a pathogenic mutation in GATA2. This is the first-ever published case of possible MonoMac syndrome with a neurological presentation. The case highlights the rarity and complexity of the diagnosis and the clinical sequelae that ensued with the patient dying of gram-negative septicaemia while receiving intravenous steroid therapy for the spinal cord lesion.

Original languageEnglish
Article numberbcr-2017-222872
Pages (from-to)1-6
Number of pages6
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - 1 Jan 2018
Externally publishedYes

Keywords

  • genetics
  • haematology (drugs and medicines)
  • infections
  • malignant disease and immunosuppression
  • neurology (drugs and medicines)

Cite this

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MonoMac syndrome with associated neurological deficits and longitudinally extensive cord lesion. / Monif, Mastura; Huq, Aamira; Chee, Lynette; Kilpatrick, Trevor.

In: BMJ Case Reports, Vol. 2018, bcr-2017-222872, 01.01.2018, p. 1-6.

Research output: Contribution to journalArticleOtherpeer-review

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N2 - We present a case of monocytopaenia and mycobacteria-related infection (MonoMac) syndrome in a 30-year-old man of Indian origin. The clinical diagnosis of GATA2 haploinsufficiency was suspected after an unusual neurological presentation on a background of myelodysplastic syndrome and childhood pulmonary tuberculosis. The patient had a longitudinally extensive spinal cord lesion and a lesion in the medulla. No obvious infective cause for the spinal cord MRI abnormality was found, and the lesions were presumed to be inflammatory in nature. The family history consisted of autosomal dominant clinical features suggestive of GATA2 haploinsufficiency. Genetic testing in peripheral leucocytes revealed a pathogenic mutation in GATA2. This is the first-ever published case of possible MonoMac syndrome with a neurological presentation. The case highlights the rarity and complexity of the diagnosis and the clinical sequelae that ensued with the patient dying of gram-negative septicaemia while receiving intravenous steroid therapy for the spinal cord lesion.

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