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February 14, 2023; 100 (7) Clinical/Scientific Note

Clinical, Imaging, and Laboratory Findings in Patients With GATA2 Deficiency Presenting With Early-Onset Ischemic Stroke

Shaia Bierman-Chow, Steven M. Holland, Amy P. Hsu, Cindy Palmer, John Lynch, Yair Mina, Hyun Joo (Sophie) Cho
First published November 10, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201569
Shaia Bierman-Chow
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Steven M. Holland
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Amy P. Hsu
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Cindy Palmer
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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John Lynch
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Yair Mina
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Hyun Joo (Sophie) Cho
From the National Institute of Neurological Disorders and Stroke (S.B.-C., J.L., Y.M., H.J.(S.)C.), National Institutes of Health, Bethesda, MD; National Institute of Allergy and Infectious Diseases (S.M.H., A.P.H.), National Institutes of Health, Bethesda, MD; National Institutes of Health Bethesda (C.P.), Maryland; and Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel.
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Citation
Clinical, Imaging, and Laboratory Findings in Patients With GATA2 Deficiency Presenting With Early-Onset Ischemic Stroke
Shaia Bierman-Chow, Steven M. Holland, Amy P. Hsu, Cindy Palmer, John Lynch, Yair Mina, Hyun Joo (Sophie) Cho
Neurology Feb 2023, 100 (7) 338-341; DOI: 10.1212/WNL.0000000000201569

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Abstract

Objective The purpose of this study was to characterize the clinical, laboratory, and imaging findings of 10 patients with GATA2 deficiency who presented with early-onset ischemic stroke.

Methods A retrospective chart review was conducted on a 127-patient cohort enrolled in the Natural History Study of GATA2 Deficiency and Related Disorders protocol at NIH between 2013 and 2021. All patients had a genetically confirmed GATA2 deficiency. Patients were included if they had evidence of an ischemic stroke through clinical evaluation and neuroimaging. Stroke diagnosis was confirmed through brain magnetic resonance imaging and/or CT.

Results Ten patients between the ages of 15 and 38 years (4 males and 6 females) were identified with at least one ischemic stroke while 6 patients experienced recurrent strokes (7.9% overall, 10/127). Stroke etiology varied and included small vessel (n = 4), large vessel (n = 1), cardioembolic (n = 1), and undetermined (n = 4). Nine patients had lupus anticoagulant, and 2 patients had a history of recurrent deep vein thrombosis.

Discussion We describe the clinical, laboratory, and imaging findings of 10 patients with GATA2 deficiency younger than 40 years who suffered one or more ischemic strokes , suggesting a link between GATA2 deficiency and stroke. This report emphasizes the need for further research to understand this unique vulnerability within this patient population.

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Submitted and externally peer reviewed. The handling editor was José Merino, MD, MPhil, FAAN.

  • Received May 5, 2022.
  • Accepted in final form September 28, 2022.
  • © 2022 American Academy of Neurology
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