Background
Since the discovery of inherited DOCK2 deficiency in 2015, the clinical and immunological phenotypes of this condition have been progressively delineated with the description of 24 cases worldwide.
Case Description:
We report the first Saudi patient, who is homozygous for a novel DOCK2 variant, c.422dup p.(Lys142Glufs*12). Like previously reported cases, the patient had early onset pervasive viral and fungal infections, live attenuated measles, mumps, and rubella (MMR) and varicella vaccine-related disseminated viral infections, lymphopenia, and elevated serum IgE level. Notably, persistent cutaneous common warts were also observed in our patient, suggesting a previously unrecognized role of DOCK2 in host defense against human papillomaviruses. The wart lesions, along with the other infections, improved upon starting prophylaxis intravenous immunoglobulin (IVIG) therapy. She is also maintained on anti-infectious therapy and awaits hematopoietic stem cell transplantation, pending a matching donor.
Conclusions
This patient expands the genetic and phenotypic spectrum of inherited DOCK2 deficiency.