X-linked immunodeficiency with hyperimmunoglobulin M (XHIM) is caused by the absence of CD40 ligand (TNFSF5 or CD154), which is normally expressed on activated CD4+ T cells. Absence of TNFS5 interrupts B cells differentiation by somatic hypermutation and heavy-chain switch from IgM to other immunoglobulin isotypes. Somatic hypermutation and immunoglobulin class switching are required to make high-affinity functional antibodies.
Alternative names
XHIM
Hyper-IgM immunodeficiency, X-linked
Hyper-IgM syndrome 1
Hyper-IgM syndrome; HIGM; IHIS
Immunodeficiency 3 Dysgammaglobulinemia, type 1
Tumor necrosis factor superfamily member 5 (CD40L, CD154)
Classification
- Combined B and T cell immunodeficiencies
- Hyper-IgM syndrome
Inheritance
X-linked
Incidence
1/1,000,000 live births in males