Immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome associated with neonatal epidermolysis bullosa acquisita

Sabina Bis, Sheilagh M. Maguiness, Stephen E. Gellis, Lynda C. Schneider, Pui Y. Lee, Luigi D. Notarangelo, Sevgi Keles, Talal A. Chatila, Birgitta A. Schmidt, Daniel D. Miller

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Abstract

We report the case of a 2-week-old boy who presented with a vesiculopustular, bullous eruption in the setting of autoimmune enteropathy, hypothyroidism, membranous nephropathy, Coombs-positive hemolytic anemia, and persistent eosinophilia. Immunologic testing revealed a deficiency of FOXP3-expressing regulatory T cells, and a diagnosis of immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome was made. Histologic analysis, immunofluorescence, and enzyme-linked immunosorbent assay confirmed the bullous eruption as epidermolysis bullosa acquisita with associated collagen VII autoantibody production. The skin lesions responded to systemic immunosuppressant therapy and have regressed after allogeneic bone marrow transplantation.

Original languageEnglish (US)
Pages (from-to)e74-e77
JournalPediatric Dermatology
Volume32
Issue number3
DOIs
StatePublished - May 1 2015

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