O Toxoplasma gondii é conhecido por infectar um número considerável de espécies de mamíferos e aves e uma proporção substancial da população humana mundial. O parasita tem uma capacidade impressionante de se disseminar no corpo do hospedeiro e emprega várias tácticas para ultrapassar a barreira hemato-encefálica altamente reguladora e residir no cérebro. Em indivíduos saudáveis, a infecção por T. gondii é largamente tolerada sem quaisquer efeitos nocivos óbvios. No entanto, a infecção primária em doentes imunodeprimidos pode resultar em doença cerebral ou sistémica aguda, e a reactivação de quistos tecidulares latentes pode levar a um resultado mortal. É imperativo que o tratamento da encefalite toxoplásmica com risco de vida seja atempado e eficaz.
Introdução
O que você precisa saber de cara
Síndrome rara associada a mutações no gene PIK3R1, caracterizada por infecções recorrentes (respiratórias, candidíase intestinal), molusco contagioso, conjuntivite e atraso no desenvolvimento. Apresenta imunodeficiência com IgA e linfócitos B diminuídos, além de alterações gastrointestinais.
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Entender a doença
Do básico ao detalhe, leia no seu ritmo
Preparando trilha educativa...
Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 13 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 38 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.
Binds to activated (phosphorylated) protein-Tyr kinases, through its SH2 domain, and acts as an adapter, mediating the association of the p110 catalytic unit to the plasma membrane. Necessary for the insulin-stimulated increase in glucose uptake and glycogen synthesis in insulin-sensitive tissues. Plays an important role in signaling in response to FGFR1, FGFR2, FGFR3, FGFR4, KITLG/SCF, KIT, PDGFRA and PDGFRB. Likewise, plays a role in ITGB2 signaling (PubMed:17626883, PubMed:19805105, PubMed:75
Agammaglobulinemia 7, autosomal recessive
A primary immunodeficiency characterized by profoundly low or absent serum antibodies and low or absent circulating B-cells due to an early block of B-cell development. Affected individuals develop severe infections in the first years of life.
Variantes genéticas (ClinVar)
612 variantes patogênicas registradas no ClinVar.
Vias biológicas (Reactome)
30 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 2 de PIK3-delta ativado
Selecione um estado ou use sua localização para ver resultados.
Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Pesquisa e ensaios clínicos
Nenhum ensaio clínico registrado para esta condição.
Publicações mais relevantes
E1021K mutation in PIK3CD gene: clinical heterogeneity and therapeutic implications in three pediatric APDS cases.
The aim of this study was to characterize the clinical manifestations, treatment responses, and prognostic indicators of activated PI3K-δ syndrome (APDS) in pediatric patients. Clinical data from three patients diagnosed with APDS in our department were retrospectively analyzed. All patients carried the same heterozygous E1021K (c.3061G > A) gain-of-function mutation in the PIK3CD gene. Immunoglobulin levels varied: IgM was normal or elevated, while IgG and IgA were normal or decreased, with the extent of change correlating with disease severity. All three children received anti-infective therapy, resulting in significant improvement in clinical symptoms and chest imaging findings. Bronchoscopic re-evaluation in Cases 1 and 2 showed marked regression of airway mucosal hyperplasia. Following diagnosis, Cases 1 and 2 received regular immunoglobulin replacement therapy, which reduced the frequency of infections. Case 2 was treated with rapamycin as targeted therapy, leading to significant improvement in hepatosplenomegaly. In conclusion, bronchoscopic detection of nodular lymphoid hyperplasia is a diagnostic hallmark of APDS. Progressive T-cell exhaustion and immunoglobulin dysregulation may serve as biomarkers of disease severity. Targeted therapy, such as rapamycin, demonstrates clinical efficacy. This case series underscores the variable expressivity of APDS even among individuals sharing the same pathogenic variant, emphasizing the need for personalized management.
Diagnostic odyssey of patients with the rare immunodeficiency activated PI3 kinase delta syndrome (APDS): case study from expert and patient surveys.
Activated phosphoinositide 3-kinase delta syndrome (APDS) is an inborn error of immunity first described in 2013. With an estimated prevalence of 1-2 per 1,000,000 individuals, it is considered an ultra-rare disease. The aim of this survey was to explore the diagnostic and therapeutic challenges of patients with APDS from the patients` and physicians` perspective in Austria, Germany, and Switzerland. A qualitative case study approach was applied. Semi-structured interviews were conducted with six patients or legal guardians of children with APDS, and four clinical immunologists with direct experience in APDS care. Transcripts were analyzed using inductive content analysis. The interviews revealed a median diagnostic delay of several years, mainly due to the rarity and phenotypic heterogeneity of APDS and the involvement of multiple specialties prior to referral to an immunologist. Many patients initially received symptomatic treatment before an underlying immune disorder was suspected. Physicians emphasized the decisive role of genetic testing for confirmation, while patients frequently described the diagnosis as a "lucky coincidence". Both groups highlighted structural barriers including limited awareness, fragmented care, and delayed access to targeted therapy. Early recognition of APDS requires specific education across specialties, wider access to genetic testing, and the development of standardized diagnostic and disease activity tools. Strengthening interdisciplinary care pathways and timely initiation of APDS-specific therapy may substantially improve outcomes in this ultra-rare immunodeficiency.
Allergic airway reactions rewired by PI3Kδ mutation.
In this issue of JEM, Golec et al. (https://doi.org/10.1084/jem.20252154) report that a mutation of PI-3 kinase underlying activated PI3K δ syndrome (APDS) impairs type 2 immunity. Surprisingly, mice with this mutation have disordered responses to allergic insults, with enhanced production of IFN-γ and a decrease in Th2 cytokines.
Natural history of clinical manifestations in activated phosphoinositide 3-kinase δ syndrome (APDS): Time-to-event analyses using the European Society for Immunodeficiencies-APDS registry.
Activated phosphoinositide 3-kinase delta (PI3Kδ) syndrome (APDS) is an ultra-rare, progressive disease characterised by immunodeficiency, immune dysregulation, and risk of malignancies. To further characterise the natural history of APDS, we analysed patient characteristics, manifestations, treatment use, and combinations of manifestations and combinations of treatments over time using longitudinal data from registration and follow-up visits in the European Society for Immunodeficiencies (ESID)-APDS registry. 140 patients were included (mean age: 17.7 years at registration; 19.1 years at last follow-up). Manifestation burden was high from childhood (patients experienced up to 9 manifestations by age 10). The number of treatments increased with age, with a 64 % probability of receiving ≥1 by age 10. Life-threatening APDS complications led to 13 deaths reported over 2.6 years' mean follow-up. These data highlight the chronic, progressive nature of APDS and its long-term impact on patients, with a high manifestation load and early mortality, despite widespread symptomatic treatment use.
Scalable generation and functional classification of genetic variants in inborn errors of immunity to accelerate clinical diagnosis and treatment.
Next-generation sequencing is pivotal for diagnosing inborn errors of immunity (IEI) but predominantly yields variants of uncertain significance (VUS), creating clinical ambiguity. Activated PI3Kδ syndrome (APDS) is caused by gain-of-function (GOF) variants in PIK3CD or PIK3R1, which encode the PI3Kδ heterodimer. We performed massively parallel base editing of PIK3CD/PIK3R1 in human T cells and mapped thousands of variants to a clinically important readout (phospho-AKT/S6), nominating >100 VUS and unannotated variants for functional classification and validating 27 hits. Leniolisib, an FDA-approved PI3Kδ inhibitor, rescued aberrant signaling and dysfunction in GOF-harboring T cells and revealed partially drug-resistant PIK3R1 hotspots that responded to novel combination therapies of leniolisib with mTORC1/2 inhibition. We confirmed these findings in T cells from APDS patients spanning the functional spectrum discovered in the screen. Integrating our screens with population-level genomic studies revealed that APDS may be more prevalent than previously estimated. This work exemplifies a broadly applicable framework for removing ambiguity from sequencing in IEI.
Publicações recentes
Mast cell mediators in hereditary angioedema.
Prenatal Molecular Diagnosis of COL2A1-Associated Stickler Syndrome: Genotype-Phenotype Correlation in a Resource-Limited Healthcare Setting.
🥉 Relato de casoPlatelet gene signatures detecting pulmonary artery stenosis in patients with pulmonary hypertension.
The global impact of imiglucerase therapy in children with Gaucher disease types 1 and 3: a real-world analysis from the International Collaborative Gaucher Group Gaucher Registry.
Monogenic lupus with SLC7A7 mutations: a retrospective study from a Chinese center.
📚 EuropePMC1 artigos no totalmostrando 54
Diagnostic odyssey of patients with the rare immunodeficiency activated PI3 kinase delta syndrome (APDS): case study from expert and patient surveys.
Frontiers in immunologyE1021K mutation in PIK3CD gene: clinical heterogeneity and therapeutic implications in three pediatric APDS cases.
Open life sciencesAllergic airway reactions rewired by PI3Kδ mutation.
The Journal of experimental medicineActivated PI3Kδ syndrome in inborn errors of immunity: diagnostic strategies and clinical challenges.
Frontiers in immunologyNatural history of clinical manifestations in activated phosphoinositide 3-kinase δ syndrome (APDS): Time-to-event analyses using the European Society for Immunodeficiencies-APDS registry.
Clinical immunology (Orlando, Fla.)Real-World Health Care Resource Utilization and Costs Among Patients with Activated Phosphoinositide 3-Kinase Delta (PI3Kδ) Syndrome in the United States.
Advances in therapySystematic literature reviews to identify epidemiological, clinical, economic and health-related quality of life evidence in activated PI3Kδ syndrome (APDS).
BMC immunologyLoss of B cell tolerance at the T2/T3a B cell transition is a convergent pathogenic mechanism in common variable immunodeficiency.
bioRxiv : the preprint server for biologyScalable generation and functional classification of genetic variants in inborn errors of immunity to accelerate clinical diagnosis and treatment.
CellThe Impact of Activated Phosphoinositide 3-Kinase δ Syndrome (APDS) on Health-Related Quality of Life (HRQoL): Elicitation of Health State Utility Values Through Time Trade-Off (TTO) and EQ-5D.
Advances in therapyDisseminated Ureaplasma urealyticum Infection and Hyperammonemic Encephalopathy in a Patient With Activated PI3K Delta Syndrome 2.
Open forum infectious diseasesSpanish Consensus on the Diagnosis and Management of Patients With Activated PI3K Delta Syndrome (APDS).
Journal of investigational allergology & clinical immunologyListeria Meningitis as an Indication of Undiagnosed Primary Immune Deficiency, Activated Phosphoinositide 3-Kinase Delta Syndrome: A Case Report.
The Pediatric infectious disease journalExpert insights on Hodgkin's lymphoma development in an activated PI3K delta syndrome patient undergoing leniolisib treatment.
Frontiers in immunologyReport of the Italian Cohort with Activated Phosphoinositide 3-Kinase δ Syndrome in the Target Therapy Era.
Journal of clinical immunologyGenetic Etiologies and Outcomes in Malignancy and Mortality in Activated Phosphoinositide 3-Kinase Delta Syndrome: A Systematic Review.
Advances in therapyA single center experience on PI3K/AKT/MTOR signaling defects: Towards pathogenicity assessment for four novel defects.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and ImmunologyCase report: Deep sequencing and long-read genome sequencing refine prior genetic analyses in families with apparent gonadal mosaicism in PIK3CD-related activated PI3K delta syndrome.
Frontiers in immunologyActivated PI3Kδ Specifically Perturbs Mouse Regulatory T Cell Homeostasis and Function Leading to Immune Dysregulation.
Journal of immunology (Baltimore, Md. : 1950)[Activated phosphoinositide 3-kinase delta syndrome: report of seven cases].
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatricsA qualitative study to explore the burden of disease in activated phosphoinositide 3-kinase delta syndrome (APDS).
Orphanet journal of rare diseasesLong-term treatment with selective PI3Kδ inhibitor leniolisib in adults with activated PI3Kδ syndrome.
Blood advancesHypogammaglobulinemia in 2 children with Zhu-Tokita-Takenouchi-Kim syndrome.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & ImmunologyA somatic splice-site variant in PIK3R1 in a patient with vascular overgrowth and low immunoglobulin levels: A case report.
Molecular genetics & genomic medicineCase Report: Successful Treatment With Monoclonal Antibodies in One APDS Patient With Prolonged SARS-CoV-2 Infection Not Responsive to Previous Lines of Treatment.
Frontiers in immunologyClinical and immunological assessment of APDS2 with features of the SHORT syndrome related to a novel mutation in PIK3R1 with reduced penetrance.
Allergologia et immunopathologiaCase Report: A Severe Paediatric Presentation of COVID-19 in APDS2 Immunodeficiency.
Frontiers in immunologyPI3Kδ coordinates transcriptional, chromatin, and metabolic changes to promote effector CD8+ T cells at the expense of central memory.
Cell reportsClinical and Cytometric Study of Immune Involvement in a Heterogeneous Cohort of Subjects With RASopathies and mTORopathies.
Frontiers in pediatricsInternational retrospective study of allogeneic hematopoietic cell transplantation for activated PI3K-delta syndrome.
The Journal of allergy and clinical immunologyEvaluation of B-cell intracellular signaling by monitoring the PI3K-Akt axis in patients with common variable immunodeficiency and activated phosphoinositide 3-kinase delta syndrome.
Cytometry. Part B, Clinical cytometryAPDS2 and SHORT Syndrome in a Teenager with PIK3R1 Pathogenic Variant.
Journal of clinical immunologySuccessful Sirolimus Treatment for Korean Patients with Activated Phosphoinositide 3-kinase δ Syndrome 1: the First Case Series in Korea.
Yonsei medical journal[Clinical and immunological characteristics of a case with activated phosphoinositide 3-kinase δ syndrome 2].
Zhonghua er ke za zhi = Chinese journal of pediatricsActivated phosphoinositide 3-kinase delta syndrome 1 and 2 (APDS 1 and APDS 2): similarities and differences based on clinical presentation in two boys.
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical ImmunologyE1021K Homozygous Mutation in PIK3CD Leads to Activated PI3K-Delta Syndrome 1.
Journal of clinical immunologySecondary C1q Deficiency in Activated PI3Kδ Syndrome Type 2.
Frontiers in immunologyA Rare Case of Activated Phosphoinositide 3-Kinase Delta Syndrome (APDS) Presenting With Hemophagocytosis Complicated With Hodgkin Lymphoma.
Journal of pediatric hematology/oncologyImmune Dysregulation and Disease Pathogenesis due to Activating Mutations in PIK3CD-the Goldilocks' Effect.
Journal of clinical immunologyPI3K Orchestrates T Follicular Helper Cell Differentiation in a Context Dependent Manner: Implications for Autoimmunity.
Frontiers in immunologyLong-term follow-up of an activated PI3K-δ syndrome 2 in patient presenting with an agammaglobulinemia phenotype.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & ImmunologyHematopoietic stem cell transplantation for progressive combined immunodeficiency and lymphoproliferation in patients with activated phosphatidylinositol-3-OH kinase δ syndrome type 1.
The Journal of allergy and clinical immunologyDisease Evolution and Response to Rapamycin in Activated Phosphoinositide 3-Kinase δ Syndrome: The European Society for Immunodeficiencies-Activated Phosphoinositide 3-Kinase δ Syndrome Registry.
Frontiers in immunologyPhosphoinositide 3-kinase δ (PI3Kδ) in respiratory disease.
Biochemical Society transactionsDisseminated abscesses due to Mycoplasma faucium in a patient with activated PI3Kδ syndrome type 2.
The journal of allergy and clinical immunology. In practiceHematopoietic cell transplantation in primary immunodeficiency - conventional and emerging indications.
Expert review of clinical immunologyType 1 diabetes mellitus associated with activated phosphatidylinositol 3-kinase delta syndrome, type 2.
Journal of diabetesSuccessful bone marrow transplantation in two sisters with activated phosphoinositide 3-kinase δ syndrome 2.
Bone marrow transplantationEarly diagnosis of PI3Kδ syndrome in a 2 years old girl with recurrent otitis and enlarged spleen.
Immunology lettersConformational disruption of PI3Kδ regulation by immunodeficiency mutations in PIK3CD and PIK3R1.
Proceedings of the National Academy of Sciences of the United States of America[Clinical and genetic analysis for activated PI3K-δ syndrome by PIK3CD gene mutation].
Zhonghua er ke za zhi = Chinese journal of pediatricsPhosphatase and tensin homolog (PTEN) mutation can cause activated phosphatidylinositol 3-kinase δ syndrome-like immunodeficiency.
The Journal of allergy and clinical immunologyActivated PI3Kδ syndrome type 2: Two patients, a novel mutation, and review of the literature.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and ImmunologyGain-of-function mutations and immunodeficiency: at a loss for proper tuning of lymphocyte signaling.
Current opinion in allergy and clinical immunologyAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
Ainda não temos associações cadastradas para Síndrome 2 de PIK3-delta ativado.
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Comunidades
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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.
- E1021K mutation in PIK3CD gene: clinical heterogeneity and therapeutic implications in three pediatric APDS cases.
- Diagnostic odyssey of patients with the rare immunodeficiency activated PI3 kinase delta syndrome (APDS): case study from expert and patient surveys.
- Allergic airway reactions rewired by PI3Kδ mutation.
- Natural history of clinical manifestations in activated phosphoinositide 3-kinase δ syndrome (APDS): Time-to-event analyses using the European Society for Immunodeficiencies-APDS registry.
- Scalable generation and functional classification of genetic variants in inborn errors of immunity to accelerate clinical diagnosis and treatment.
- Mast cell mediators in hereditary angioedema.
- Prenatal Molecular Diagnosis of COL2A1-Associated Stickler Syndrome: Genotype-Phenotype Correlation in a Resource-Limited Healthcare Setting.
- Platelet gene signatures detecting pulmonary artery stenosis in patients with pulmonary hypertension.
- The global impact of imiglucerase therapy in children with Gaucher disease types 1 and 3: a real-world analysis from the International Collaborative Gaucher Group Gaucher Registry.
- Monogenic lupus with SLC7A7 mutations: a retrospective study from a Chinese center.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:693681(Orphanet)
- MONDO:0014453(MONDO)
- GARD:16046(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
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
