What happens in this disease?
Lymphocytes are white blood cells that protect the body from germs. In SCID, these cells, especially T cells, cannot develop or do not work. The immune system cannot fight off bacteria, viruses and fungi. The disease is caused by a change in one of more than 20 genes. The most common type is X-linked SCID.
Which symptoms can occur?
In the first months, babies are protected by antibodies passed on from the mother. Symptoms usually begin between 3 and 6 months.
- Frequent and severe infections, for example pneumonia
- Infections that do not respond well to treatment
- Thrush in the mouth, meaning a fungal infection
- Long-lasting diarrhea
- Poor weight gain and slow growth
- Skin rash
How is it diagnosed?
In some countries, it is detected shortly after birth through newborn screening. This test measures a trace of T cell production in blood from the heel. If the result is low, a blood count and lymphocyte tests are done. A genetic test determines the type of the disease.
Treatment and care
The most effective treatment and the only lasting solution is a stem cell (bone marrow) transplant. The transplant is preferably done in the first months of life. Until the transplant, the baby is protected from infections and live vaccines are not given. For the type caused by ADA deficiency, enzyme treatment may be used. For this type, there is also a gene therapy approved in Europe. Gene therapy for the other types is being researched. The doctor who follows the disease decides which treatment is suitable.
For the family: inheritance and genetic counselling
Most types are passed on through recessive inheritance. For a couple who are both carriers, the chance of having an affected child is 1 in 4 in each pregnancy. Recessive diseases may be more common in marriages between relatives. It has been reported to be more common in families of Turkish origin. The X-linked type, on the other hand, mostly affects boys. A mother who is a carrier has a 1 in 4 chance of having an affected boy in each pregnancy. Genetic counselling guides future pregnancies.