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The heterogeneity of lung involvement in vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome: a case of hypersensitivity pneumonitis-like pattern

Authors

Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a recently characterized disease associated with somatic mutations in the UBA1 gene, which cause dysregulation of ubiquitin-mediated processes. This case describes a 71-year-old male patient with VEXAS syndrome who presented with refractory lung inflammation with a pattern similar to computed tomography hypersensitivity pneumonitis, a novel finding in VEXAS syndrome. The presented clinical case highlights the protean involvement of the lung in VEXAS syndrome and emphasizes the importance of considering interstitial lung disease in the differential diagnosis.

Beck DB, Ferrada MA, Sikora KA, Ombrello AK, Collins JC, Pei W, et al. Somatic mutations in UBA1 and severe adult-onset autoinflammatory disease. N Engl J Med 2020; 383: 2628-38. DOI: https://doi.org/10.1056/NEJMoa2026834
van der Made CI, Potjewijd J, Hoogstins A, Willems HPJ, Kwakernaak AJ, de Sevaux RGL, et al. Adult-onset autoinflammation caused by somatic mutations in UBA1: a Dutch case series of patients with VEXAS. J Allergy Clin Immunol 2022; 149: 432-9.e4. DOI: https://doi.org/10.1016/j.jaci.2021.05.014
Borie R, Debray MP, Guedon AF, Mekinian A, Terriou L, Lacombe V, et al. Pleuropulmonary manifestations of vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome. Chest 2023; 163: 575-85. DOI: https://doi.org/10.1016/j.chest.2022.10.011
Kouranloo K, Ashley A, Zhao SS, Dey M. Pulmonary manifestations in VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome: a systematic review. Rheumatol Int 2023; 43: 1023-32. DOI: https://doi.org/10.1007/s00296-022-05266-2
Chang TK, Shravage BV, Hayes SD, Powers CM, Simin RT, Wade Harper J, et al. Uba1 functions in Atg7- and Atg3-independent autophagy. Nat Cell Biol 2013; 15: 1067-78. DOI: https://doi.org/10.1038/ncb2804
Georgin‐Lavialle S, Terrier B, Guedon AF, Heiblig M, Comont T, Lazaro E, et al. Further characterization of clinical and laboratory features in VEXAS syndrome: large‐scale analysis of a multicentre case series of 116 French patients. Br J Dermatol 2022; 186: 564-74. DOI: https://doi.org/10.1111/bjd.20805

How to Cite

Iannone, C., Pellico, M., Campochiaro, C., Tescaro, L., Zompatori, M., Caminati, A., … Caporali, R. (2024). The heterogeneity of lung involvement in vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome: a case of hypersensitivity pneumonitis-like pattern. Reumatismo, 76(2). https://doi.org/10.4081/reumatismo.2024.1611

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