Histiocitose hereditária sistêmica, com achados cutâneos característicos acompanhando manifestações sistêmicas. A síndrome H refere-se aos principais achados clínicos de hiperpigmentação, hipertricose, hepatoesplenomegalia, anomalias cardíacas, perda auditiva, hipogonadismo, baixa estatura e, ocasionalmente, hiperglicemia/diabetes mellitus. Devido às características clínicas sobrepostas, considera-se agora que a síndrome H inclui hipertricose pigmentada com síndrome de diabetes mellitus dependente de insulina (PHID), histiocitose de Faisalabad (FHC) e histiocitose sinusal familiar com linfadenopatia maciça (FSHML).
Introdução
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Histiocitose hereditária sistêmica, com achados cutâneos característicos acompanhando manifestações sistêmicas. A síndrome H refere-se aos principais achados clínicos de hiperpigmentação, hipertricose, hepatoesplenomegalia, anomalias cardíacas, perda auditiva, hipogonadismo, baixa estatura e, ocasionalmente, hiperglicemia/diabetes mellitus. Devido às características clínicas sobrepostas, considera-se agora que a síndrome H inclui hipertricose pigmentada com síndrome de diabetes mellitus dependente de insulina (PHID), histiocitose de Faisalabad (FHC) e histiocitose sinusal familiar com linfadenopatia maciça (FSHML).
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 27 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 84 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
Uniporter that mediates the facilitative transport of nucleoside across lysosomal and mitochondrial membranes (PubMed:15701636, PubMed:19164483, PubMed:20595384, PubMed:28729424). Functions as a non-electrogenic Na(+)-independent transporter (PubMed:15701636, PubMed:19164483, PubMed:28729424). Substrate transport is pH-dependent and enhanced under acidic condition, probably reflecting the location of the transporter in acidic intracellular compartments (PubMed:15701636, PubMed:19164483, PubMed:2
Lysosome membraneLate endosome membraneMitochondrion membraneCell membrane
Histiocytosis-lymphadenopathy plus syndrome
A syndrome characterized by the combination of features from 2 or more of four histiocytic disorders, originally thought to be distinct: Faisalabad histiocytosis (FHC), sinus histiocytosis with massive lymphadenopathy (SHML), H syndrome, and pigmented hypertrichosis with insulin-dependent diabetes mellitus syndrome (PHID). FHC features include joint deformities, sensorineural hearing loss, and subsequent development of generalized lymphadenopathy and swellings in the eyelids that contain histiocytes. SHML causes lymph node enlargement in children frequently accompanied by fever, leukocytosis, elevated erythrocyte sedimentation rate, and polyclonal hypergammaglobulinemia. H syndrome is characterized by cutaneous hyperpigmentation and hypertrichosis, hepatosplenomegaly, heart anomalies, and hypogonadism; hearing loss is found in about half of patients. PHID is characterized by predominantly antibody-negative insulin-dependent diabetes mellitus associated with pigmented hypertrichosis and variable occurrence of other features of H syndrome.
Variantes genéticas (ClinVar)
79 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 519 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
3 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome H
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Outros ensaios clínicos
Publicações mais relevantes
Redox imbalance and NLRP3 activation: H syndrome mistaken for CAPS-a case report.
H syndrome is a rare autosomal recessive disorder caused by mutations in SLC29A3, encoding the nucleoside transporter hENT3. Its heterogeneous clinical presentation often includes skin hyperpigmentation, systemic inflammation, endocrinopathies and sensorineural hearing loss. However, typical cutaneous signs may be absent, leading to diagnostic challenges. The objective was to describe a patient with H syndrome misdiagnosed until adulthood as having cryopyrin-associated periodic syndrome (CAPS), due to overlapping clinical and functional features. We conducted clinical, immunological, genetic and functional assessments in a 24-year-old male with a complex history of early-onset urticarial rash, fever, hearing loss, oral ulcers, colitis and episodic inflammation. Genetic analyses included whole-exome sequencing (WES) and segregation study by quantitative PCR (qPCR). Functional assays evaluated IL-1β secretion, ASC speck formation, reactive oxygen species (ROS) production and type I interferon signature. The patient showed enhanced and accelerated IL-1β secretion and increased ASC speck formation in CD14+ cells after lipopolysaccharide (LPS) stimulation, indicating NLRP3 inflammasome hyperactivation, hallmark features of CAPS. ROS production was significantly elevated in both granulocytes and monocytes, even at baseline. A type I interferon signature was intermittently positive. Genetic testing ultimately revealed a homozygous deletion of exon 2 in the SLC29A3 gene, confirming H syndrome. This case highlights the phenotypic overlap between H syndrome and CAPS, including shared inflammasome dysregulation. Absence of typical skin hyperpigmentation delayed diagnosis despite early-onset systemic inflammation and partial response to IL-1 blockade. Functional assays may support diagnostic refinement in autoinflammatory syndromes with atypical features or inconclusive genetics.
Suspected meningeal infiltration in H syndrome: A case report.
New cases expand the genotype, phenotype and therapeutic landscape of H syndrome.
The lysosomal carrier SLC29A3 supports antibacterial signaling, and promotes autophagy by activating TRPML1 in murine dendritic cells.
The solute carrier (SLC)29A3 exports nucleosides from lysosomes into the cytosol, maintaining solute homeostasis and providing metabolic intermediates for cellular processes. Loss-of-function mutations in SLC29A3 cause H syndrome, characterized by histiocytosis, hyperinflammation, and immunodeficiency. While dysfunctions in various cell types contribute to H syndrome and to SLC29A3 deficiency in mice, the mechanisms driving hyperinflammation and immunodeficiency are incompletely understood. Remarkably, the possible role played by dendritic cells (DCs), the most efficient antigen (Ag)-presenting cells and the main cellular link between innate and adaptive immunity, remains unknown. We show that, in murine DCs, SLC29A3 is recruited to phagosomes after bacterial capture, maintains phagosomal pH homeostasis, and ensures optimal antimicrobial phagosomal signaling to the production of IL-6, IL-12, pro-IL-1β, and CCL22. In addition, SLC29A3 promotes Ag presentation on MHC-II molecules to initiate adaptive immune responses. Notably, SLC29A3 supports the activity of the lysosomal calcium channel TRPML1, promoting the nuclear translocation of transcription factor TFEB and inducing autophagy, a major anti-inflammatory mechanism. Overexpression of human SLC29A3, but not the transport mutant G437R, in SLC29A3-deficient murine DCs restores cytokine production in response to bacterial phagocytosis, suggesting that SLC29A3 transport activity is required to drive phagosomal signaling. Our data suggest that SLC29A3 supports and controls immune function in DCs by promoting effective antimicrobial signaling and Ag presentation, and inducing autophagy. Our findings also uncover a TRPML1-dependent mechanism by which SLC29A3 activates TFEB and suggest that defects in phagosomal antibacterial signaling, TFEB activation, and autophagy may contribute to immunodeficiency and hyperinflammation in SLC29A3 disorders.
H syndrome presenting with bilateral cheek enlargement and an SLC29A3 gene variant.
An adolescent girl presents with bilateral cheek enlargement, hyperpigmentation and hypertrichosis of the lower extremities with otological, cardiac, endocrine, and hepatosplenic involvement. Clinical findings supplemented by histopathological and wide exome sequencing results led to the diagnosis of H syndrome. The genetic testing showed a homozygous frameshift mutation in the SLC29A3 gene involving unique exon and codons. This case highlights the unique characteristics of H syndrome observed in a Filipino female with a variant of the SLC29A3 gene mutation.
Publicações recentes
Familial SLC29A3-related histiocytosis with presumed choroidal infiltration: expanding the spectrum of histiocytosis-lymphadenopathy plus syndrome.
Suspected meningeal infiltration in H syndrome: A case report.
Redox imbalance and NLRP3 activation: H syndrome mistaken for CAPS-a case report.
The lysosomal carrier SLC29A3 supports antibacterial signaling, and promotes autophagy by activating TRPML1 in murine dendritic cells.
A rare case of H syndrome with severe multisystem involvement: Clinical challenges in low-resource healthcare settings.
📚 EuropePMC110 artigos no totalmostrando 105
Suspected meningeal infiltration in H syndrome: A case report.
JAAD case reportsRedox imbalance and NLRP3 activation: H syndrome mistaken for CAPS-a case report.
Rheumatology (Oxford, England)The lysosomal carrier SLC29A3 supports antibacterial signaling, and promotes autophagy by activating TRPML1 in murine dendritic cells.
Proceedings of the National Academy of Sciences of the United States of AmericaA rare case of H syndrome with severe multisystem involvement: Clinical challenges in low-resource healthcare settings.
The Journal of international medical researchNew cases expand the genotype, phenotype and therapeutic landscape of H syndrome.
British journal of haematologyAllogeneic hematopoietic cell transplantation rescues congenital red cell aplasia in H syndrome due to SLC29A3 mutations.
HaematologicaThe lysosomal carrier SLC29A3 supports anti-bacterial signaling and promotes autophagy by activating TRPML1 in mouse dendritic cells.
bioRxiv : the preprint server for biology'VACTERL-H in newborn: A rare case report'.
Journal of neonatal-perinatal medicineProfile of monogenic diabetes: a Pan-India study.
Diabetes research and clinical practice[Azygos continuation of the inferior vena cava associated with "H syndrome"].
La Revue de medecine interneH syndrome presenting with bilateral cheek enlargement and an SLC29A3 gene variant.
BMJ case reportsA case report on H syndrome among patients with diabetes mellitus.
BioinformationFDG PET Scan in Cutaneous Rosai-Dorfman-Destombes Disease.
Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, IndiaSterile osteomyelitis: a cardinal sign of autoinflammation.
ReumatologiaH syndrome with bilateral choroidal osteoma: Coincidence or association?
European journal of ophthalmologySLC29A3 Pathogenic Variants Resulting in Dural Based Fibroinflammatory Mass Lesions and H Syndrome Treated With Cobimetinib: A Case Report.
Neurology. GeneticsH syndrome: A histiocytosis-lymphadenopathy plus syndrome. A comprehensive review of the literature.
Hematology/oncology and stem cell therapyRheumatological manifestations of H syndrome.
ReumatologiaCochlear implantation in syndromic patients: difficulties and lessons learnt.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck SurgeryStudy of Akabane disease in an Iranian dairy herd: a re-emerging disease.
Veterinary research communicationsH Syndrome: Three New Cases from Morocco.
SkinmedAvalanche burial pathophysiology - a unique combination of hypoxia, hypercapnia and hypothermia.
The Journal of physiologyA novel start-loss mutation of the SLC29A3 gene in a consanguineous family with H syndrome: clinical characteristics, in silico analysis and literature review.
BMC medical genomicsClinical Progression and Manifestations of H Syndrome: A Case Report of Failed Treatment Option.
The American journal of case reportsCurrent phenotypic and genetic spectrum of syndromic deafness in Tunisia: paving the way for precision auditory health.
Frontiers in geneticsCombination of four features of SLC29A3 spectrum disorder in a child: A case report.
Pediatric dermatologyCases with the H syndrome presenting with skin and bone findings.
The Australasian journal of dermatologyRheumatological complaints in H syndrome: from inflammatory profiling to target treatment in a case study.
Pediatric rheumatology online journalPigmented Hypertrichosis with Insulin-Dependent Diabetes Mellitus Syndrome: A Case Series.
Hormone research in paediatricsEquilibrative nucleotide transporter ENT3 (SLC29A3): A unique transporter for inherited disorders and cancers.
Experimental cell researchHyperglycemia with hypogonadism and growth hormone deficiency in a 17-year-old male with H syndrome: the first case report from Syria.
BMC endocrine disordersHyperactive TLR signaling: putting the "H" in H syndrome.
BloodA Rare Autoimmune Disease Detected in the Differential Diagnosis of Immunodeficiency: Histiocytosis-lymphadenopathy Plus Syndrome.
Iranian journal of allergy, asthma, and immunologyLoss of function of ENT3 drives histiocytosis and inflammation through TLR-MAPK signaling.
BloodH syndrome treated with Tocilizumab: two case reports and literature review.
Frontiers in immunologyNonfamilial VACTERL-H Syndrome in a Dizygotic Twin: Prenatal Ultrasound and Postnatal 3D CT Findings.
Medicina (Kaunas, Lithuania)H Syndrome Presenting with Sinus of Valsalva Aneurysm and Possible Founder Mutation (p.Arg134cys) in Indian Patients.
Indian journal of dermatologyThe SLC29A3 variant, neutrophilic dermatosis, and hyperferritinemia imitate systemic juvenile idiopathic arthritis in a Saudi child: a case report.
Journal of rheumatic diseasesOCT2 expression in histiocytoses.
Virchows Archiv : an international journal of pathologyH syndrome mimicking Erdheim Chester disease: new entity and therapeutic perspectives.
HaematologicaA case report of H-syndrome from Baghdad Medical City treated with tocilizumab.
Clinical case reportsRenal Involvement in H Syndrome, A Rare Cause of Diabetes Mellitus: Case Report.
Endocrine, metabolic & immune disorders drug targetsRosai-Dorfman Disease between Proliferation and Neoplasia.
CancersUnusual facial lesions in H syndrome.
Clinical case reportsCase report of H-syndrome with a review from a rheumatological perspective.
BMJ case reportsHistiocytosis-lymphadenopathy plus syndrome revealed by repeated secondary hemophagocytic lymphohistiocytosis.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and ImmunologyH syndrome caused by a novel P324S mutation in SLC29A3 gene.
International journal of dermatologyReview of the current literature on H syndrome treatment.
Journal of family medicine and primary careH Syndrome: Report of The First Case in African Ethnicity.
CureusEffects of Carbon Dioxide and Temperature on the Oxygen-Hemoglobin Dissociation Curve of Human Blood: Implications for Avalanche Victims.
Frontiers in medicinePhenotypic intrafamilial variability including H syndrome and Rosai-Dorfman disease associated with the same c.1088G > A mutation in the SLC29A3 gene.
Human genomicsThe Epidemiology and Genetic Analysis of Children With Idiopathic Type 1 Diabetes in the State of Qatar.
Journal of the Endocrine SocietyH syndrome: A review of treatment options and a hypothesis of phenotypic variability.
Dermatologic therapyPatient with H syndrome, cardiogenic shock, multiorgan infiltration, and digital ischemia.
Pediatric rheumatology online journalEfficacy of tocilizumab in adult H syndrome: a promising therapeutic option.
International journal of dermatology'H-syndrome': a multisystem genetic disorder with cutaneous clues.
BMJ case reportsMermaid syndrome associated with VACTERL-H syndrome.
Folia medicaH syndrome with low bone mineral density associated with hypovitaminosis D and low insulin-like growth factor 1.
JAAD case reportsMultimodality imaging of constrictive pericarditis in H syndrome.
Echocardiography (Mount Kisco, N.Y.)H syndrome: A rare multisystem genodermatosis associated with a novel finding of retinal angioma.
Journal of paediatrics and child healthPseudo-Meigs' Syndrome in Tunisian H Syndrome Female Patient: First Case Reported.
The application of clinical geneticsNeonatal Urine Screening Program in the Province of Quebec: Technological Upgrade from Thin Layer Chromatography to Tandem Mass Spectrometry.
International journal of neonatal screeningGenetic disorders with symptoms mimicking rheumatologic diseases: A single-center retrospective study.
European journal of medical geneticsHyperpigmented plaques with hypertrichosis in a patient with diabetes mellitus.
Pediatric dermatologyGlomerular involvement in children with H syndrome.
Pediatric nephrology (Berlin, Germany)Identification of Critical Transcriptomic Signaling Pathways in Patients with H Syndrome and Rosai-Dorfman Disease.
Journal of clinical immunologyEffects of hypothermia, hypoxia, and hypercapnia on brain oxygenation and hemodynamic parameters during simulated avalanche burial: a porcine study.
Journal of applied physiology (Bethesda, Md. : 1985)H Syndrome retrospectively diagnosed: The importance of recognizing cutaneous signs.
Clinical case reportsMycophenolate mofetil treatment of an H syndrome patient with a SLC29A3 mutation.
Dermatologic therapyH syndrome with a novel homozygous SLC29A3 mutation in two sisters.
Pediatric dermatologyH syndrome: A rare genodermatosis.
Journal of cosmetic dermatologyMonogenic diabetes: A single center experience from South India.
Pediatric diabetesMutation in the SLC29A3 Gene in an Egyptian Patient with H Syndrome: A Case Report and Review of Literature.
Journal of pediatric geneticsH syndrome with a possibly new immunological phenotype.
International journal of dermatologyAutoinflammation in addition to combined immunodeficiency: SLC29A3 gene defect.
Molecular immunologyHomozygosity for a novel large deletion in SLC29A3 in a patient with H syndrome.
Pediatric dermatologyA novel homozygous frame-shift mutation in the SLC29A3 gene: a new case report and review of literature.
BMC medical geneticsAdult stem cell deficits drive Slc29a3 disorders in mice.
Nature communicationsH syndrome - the first report in Malaysia.
International journal of dermatologyH Syndrome - A Case Report.
Indian dermatology online journalH syndrome with possible new phenotypes.
JAAD case reportsA novel 3' untranslated region mutation in the SLC29A3 gene associated with pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus syndrome.
Pediatric diabetesIdentification of a novel homozygous frameshift mutation in SLC29A3 gene in a case with H syndrome from Iran.
Current research in translational medicineSkin-limited H syndrome in a Chinese man.
The Australasian journal of dermatologyClinical, Histochemical, and Molecular Study of Three Turkish Siblings Diagnosed with H Syndrome, and Literature Review.
Hormone research in paediatricsA Turkish girl with H syndrome: stunted growth and development of autoimmune insulin dependent diabetes mellitus in the 6th year of diagnosis.
Journal of pediatric endocrinology & metabolism : JPEMThe H Syndrome: A Genodermatosis.
CureusH syndrome: Clinical, histological and genetic investigation in Tunisian patients.
The Journal of dermatologyA Tale of H Syndrome with Typical Radiographic Findings.
Indian journal of dermatologyThe histopathology and phenotypic variability in H syndrome.
Clinical case reportsH Syndrome: A Case Report and Review of Literature.
Indian journal of dermatologyUsefulness and Utility of NACO Regime in the Management of Sexually Transmitted Infections: A Pilot Study.
Indian journal of dermatologyH Syndrome: A Rare Genodermatosis Imaged With 18F-FDG PET/CT.
Clinical nuclear medicineH syndrome: 5 new cases from the United States with novel features and responses to therapy.
Pediatric rheumatology online journalSkin-Dominant Phenotype in a Patient with H Syndrome: Identification of a Novel Mutation in the SLC29A3 Gene.
Cytogenetic and genome researchH syndrome with histological features of Langerhans cell histiocytosis.
Indian journal of dermatology, venereology and leprologyMale fertility and skin diseases.
Reviews in endocrine & metabolic disordersCompound heterozygous SLC29A3 mutation causes H syndrome in a Moroccan patient: A case report.
Current research in translational medicine[H syndrome: First reported paediatric case in Latin America].
Revista chilena de pediatriaVesico-amniotic shunting for lower urinary tract obstruction in a fetus with VACTERL association.
Congenital anomaliesIdentification of a Novel Mutation in Solute Carrier Family 29, Member 3 in a Chinese Patient with H Syndrome: Corrigendum.
Chinese medical journalCase of H syndrome with massive skin involvement, retroperitoneal fibrosis and Raynaud's phenomenon with a novel mutation in the SLC29A3 gene.
The Journal of dermatologyH syndrome: a multifaceted histiocytic disorder with hyperpigmentation and hypertrichosis.
Acta dermato-venereologicaVariability in the Manifestations and Evolution of Symptoms in a Patient with H Syndrome.
Indian journal of pediatricsIdentification of a novel mutation in solute carrier family 29, member 3 in a Chinese patient with H syndrome.
Chinese medical journalAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Redox imbalance and NLRP3 activation: H syndrome mistaken for CAPS-a case report.
- Suspected meningeal infiltration in H syndrome: A case report.
- New cases expand the genotype, phenotype and therapeutic landscape of H syndrome.
- The lysosomal carrier SLC29A3 supports antibacterial signaling, and promotes autophagy by activating TRPML1 in murine dendritic cells.Proceedings of the National Academy of Sciences of the United States of America· 2025· PMID 41284877mais citado
- H syndrome presenting with bilateral cheek enlargement and an SLC29A3 gene variant.
- Familial SLC29A3-related histiocytosis with presumed choroidal infiltration: expanding the spectrum of histiocytosis-lymphadenopathy plus syndrome.
- A rare case of H syndrome with severe multisystem involvement: Clinical challenges in low-resource healthcare settings.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:168569(Orphanet)
- OMIM OMIM:602782(OMIM)
- MONDO:0011273(MONDO)
- Sindrome Hemolitico-Uremica Atipica(PCDT · Ministério da Saúde)
- GARD:10239(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q31841284(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
