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The Joneses were referred to a clinical geneticist because their 6-month-old daughter was failing to grow adequately and was having recurrent infections. The geneticist took a detailed family history (which was uninformative) and a medical history of their daughter. He discovered that their daughter had a history of a constant cough and wheeze that was becoming progressively worse, had difficulty gaining weight (failure to thrive), and had an extensive history of yeast infection (thrush) in her mouth. The geneticist did a simple blood test to check their daughter’s white blood count and determined that she had severe combined immunodeficiency (SCID). The geneticist explained that SCID is an immune deficiency that causes a marked susceptibility to infections. The defining characteristic is usually a severe defect in both the T- and B-lymphocyte systems. This results in one or more infections within the first few months of life that are serious and may even be life-threatening. Based on the family history, it was possible that their daughter had inherited a mutant allele from each of them and therefore was homozygous for a gene that causes SCID. If so, each time the Joneses had a child, there would be a 25% chance that the child would have SCID. Prenatal testing is available to determine whether the developing fetus has SCID. Genetic testing showed that both parents were heterozygous carriers of a mutant allele of the adenosine deaminase (ADA) gene and that the daughter was homozygous for this mutation. Are there any treatment options available for ADA-deficient SCID?

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Human Heredity: Principles and Iss...

11th Edition
Michael Cummings
Publisher: Cengage Learning
ISBN: 9781305251052

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BuyFindarrow_forward

Human Heredity: Principles and Iss...

11th Edition
Michael Cummings
Publisher: Cengage Learning
ISBN: 9781305251052
Chapter 17, Problem 1CS
Textbook Problem
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The Joneses were referred to a clinical geneticist because their 6-month-old daughter was failing to grow adequately and was having recurrent infections. The geneticist took a detailed family history (which was uninformative) and a medical history of their daughter. He discovered that their daughter had a history of a constant cough and wheeze that was becoming progressively worse, had difficulty gaining weight (failure to thrive), and had an extensive history of yeast infection (thrush) in her mouth. The geneticist did a simple blood test to check their daughter’s white blood count and determined that she had severe combined immunodeficiency (SCID).

The geneticist explained that SCID is an immune deficiency that causes a marked susceptibility to infections. The defining characteristic is usually a severe defect in both the T- and B-lymphocyte systems. This results in one or more infections within the first few months of life that are serious and may even be life-threatening. Based on the family history, it was possible that their daughter had inherited a mutant allele from each of them and therefore was homozygous for a gene that causes SCID. If so, each time the Joneses had a child, there would be a 25% chance that the child would have SCID. Prenatal testing is available to determine whether the developing fetus has SCID.

Genetic testing showed that both parents were heterozygous carriers of a mutant allele of the adenosine deaminase (ADA) gene and that the daughter was homozygous for this mutation. Are there any treatment options available for ADA-deficient SCID?

Summary Introduction

To determine: The treatment options for adenosine deaminase (ADA)-deficient severe combined immunodeficiency disease (SCID).

Introduction: Mr. and Mrs. J were referred to a clinical geneticist because their 6-month-old daughter was not growing appropriately. After the examination, the doctor observed that their daughter had a constant cough, wheeze, and extensive yeast infection. The doctor also took a blood test and determined that their daughter has suffered from SCID. It was also found that their daughter had inherited mutant allele for SCID from the parents.

Explanation of Solution

According to the case study, both the parents have the heterozygous mutant allele for ADA deficiency. The daughter has received both the mutant alleles from both father and mother and has become homozygous for the condition. ADA-deficient SCID is an immunodeficiency disorder. This condition causes a reduction in the synthesis of immune cells. In the absence of immune cells, the person would become immunocompromised. A person with ADA-SCID would become susceptible to infections. The possible treatment of this disease can be done by medicating the person with immune-modulating drugs.

Gene therapy is also a good option for the treatment of ADA-SCID. Using gene therapy, the gene of adenosine deaminase deficiency is replaced with normal genes. This would stimulate the immune system and improve the condition of the patient. However, the success rate of gene therapy is very low. In order to prevent the patient from infections, the patient must be kept in a sterile environment. However, there is no appropriate treatment for ADA-SCID that can cure this disease.

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