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Blood, 1 February 2005, Vol. 105, No. 3, pp. 1195-1197.
Prepublished online as a Blood First Edition Paper on September 30, 2004; DOI 10.1182/blood-2004-07-2972.


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Submitted August 2, 2004
Accepted September 27, 2004

Early-onset sarcoidosis and CARD15 mutations with constitutive nuclear factor-{kappa}B activation: common genetic etiology with Blau syndrome

Nobuo Kanazawa*, Ikuo Okafuji, Naotomo Kambe, Ryuta Nishikomori, Mami Nakata-Hizume, Sonoko Nagai, Akihiko Fuji, Takenosuke Yuasa, Akira Manki, Yoshihiko Sakurai, Mitsuru Nakajima, Hiroko Kobayashi, Ikuma Fujiwara, Hiroyuki Tsutsumi, Atsushi Utani, Chikako Nishigori, Toshio Heike, Tatsutoshi Nakahata, and Yoshiki Miyachi

Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Department of Internal Medicine, Holy Spirit Hospital, Nagoya, Japan
Yuasa Ophthalmic Clinic, Osaka, Japan
Department of Pediatrics, Okayama University Medical School, Okayama, Japan
Department of Pediatrics, Nara Medical University, Nara Kashihara, Japan
Department of Internal Medicine II, Fukushima Medical University School of Medicine, Fukushima, Japan
Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Japan

* Corresponding author; email: nkanazaw{at}kuhp.kyoto-u.ac.jp.

Early-onset sarcoidosis (EOS) and inheritable Blau syndrome (BS) share characteristic clinical features of juvenile-onset systemic granulomatosis syndrome that mainly affects skin, joints and eyes. However, no direct evidence has ever been shown for the possible common origin of these two diseases. Recent discovery of CARD15 mutations in BS families encouraged us to investigate similar CARD15 mutations in EOS patients. Among 10 EOS cases retrospectively collected in Japan, heterozygous missense mutations were found in 9 cases; 4 showed a C1000T (R334W in amino acid change) that has been reported in BS, 4 showed novel A1487T (H496L), T1538C (M513T), A1813C (T605P) and C2010A (N670K), and one case showed double C1146G (D382E)/G1834A (A612T) mutations on different alleles. All these 6 variants of CARD15 showed increased basal nuclear factor (NF)-{kappa}B activity. These findings indicate that the majority of EOS and BS share the common genetic etiology of CARD15 mutations that cause constitutive NF-{kappa}B activation.


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