Chediak-Higashi Syndrome

WHAT IS IT?

Chediak-Higashi syndrom is an autosomal recessive immunological disorder that is characterized by partial occulocutaneous albinism and recurrent cutaneous infections.

WHAT CAUSES IT?

This condition is caused by a defect in the lysosomal trafficking regulator gene (LYST): this mutation results in the microtubule dysfunction during the phagosome-lysosome fusion. Ultimately, this mutation manifests as impaired phagosome lysosome fusion, compromising the ability of phagocytes (like neutrophils) to combat against pathogens. 

WHY IS IT CONCERNING MEDICALLY?

This immunodeficiency will result in recurrent pyogenic infections. Furthermore, abnormal melanin stage in melanocytes causes partial oculocutaneous albinism. 

WHAT IS THE INTIAL PRESENTATION?

Patient Chief Complaints:

  • Skin infections 

Detected Medical Problems:

  • Pancytopenia 
WHAT ARE IMPORTANT ELEMENTS OF THE MEDICAL HISTORY?

Risk Factors:

 

Medical History:

WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

 

Neurological Exam:

  • Nystagmus 
  • Peripheral and cranial neuropathies  
CLINICAL WORKUP: SERUM STUDIES

Peripheral blood smearthis can demonstrate the presence of abnormal giant lysosomal inclusions in granulocytes and platelets.

Presence of giant lysosome granules in a patient with Chediak-Higashi syndrome (source)
CLINICAL WORKUP: IMAGING

 

CLINICAL WORKUP: MICROSCOPY

Light microscopythis can demonstrate the presence of abnormal giant lysosomal inclusions in granulocytes and platelets 

HOW DO WE NARROW THE DIFFERENTIAL?

Conditions that present similarly and how to exclude them:

 

WHAT IS OUR THRESHOLD FOR DIAGNOSING THIS CONDITION?

 

PATIENT MANAGMENT: SYMPTOM RELEIF

 

PATIENT MANAGEMENT: DISEASE TREATMENT

 

PATIENT MANAGEMENT: PROPHYLACTIC MEASURES

 

COULD THIS HAVE BEEN PREVENTED?

 

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

 

Page Updated: 04.06.2017