Wiskott-Aldrich syndrome

Last updated: June 19, 2025

Wiskott-Aldrich syndrome

Block 2

Block 2

Pentose phosphate pathway
Diabetes mellitus
Disorders of carbohydrate metabolism: Pathology review
Amino acid metabolism
Disorders of amino acid metabolism: Pathology review
Dyslipidemias: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Diabetes mellitus (Type 2): Clinical sciences
Fatty acid synthesis
Wernicke-Korsakoff syndrome
Alcohol-induced hepatitis: Clinical sciences
Diabetes mellitus: Clinical
Diabetes mellitus (Type 1): Clinical sciences
Fetal alcohol syndrome
Diabetes mellitus: Pathology review
Alcohol use disorder
Alcohol-associated liver disease
Enterococcus
Staphylococcus epidermidis
Mycobacterium tuberculosis (Tuberculosis)
Neisseria gonorrhoeae
Corynebacterium diphtheriae (Diphtheria)
Water-soluble vitamin deficiency and toxicity: B1-B7: Pathology review
Water-soluble vitamin deficiency and toxicity: B9, B12 and vitamin C: Pathology review
Vitamin D
Klebsiella pneumoniae
Vitamin B12 deficiency
Folate (Vitamin B9) deficiency
Streptococcus viridans
Clostridium perfringens
Chlamydia trachomatis
Staphylococcus saprophyticus
Staphylococcus aureus
Mycobacterium leprae
Clostridium botulinum (Botulism)
Bacillus anthracis (Anthrax)
Actinomyces israelii
Clostridium tetani (Tetanus)
Streptococcus agalactiae (Group B Strep)
Bacillus cereus (Food poisoning)
Listeria monocytogenes
Pseudomonas aeruginosa
Nocardia
Haemophilus influenzae
Neisseria meningitidis
Treponema pallidum (Syphilis)
Human papillomavirus
Herpes simplex virus
Neuraminidase inhibitors
Human herpesvirus 6 (Roseola)
Borrelia burgdorferi (Lyme disease)
Adenovirus
Yersinia pestis (Plague)
Rhinovirus
Rubella virus
Influenza virus
Mumps virus
Measles virus
Human herpesvirus 8 (Kaposi sarcoma)
Herpesvirus medications
Plasmodium species (Malaria)
Coxiella burnetii (Q fever)
Ehrlichia and Anaplasma
Bartonella henselae (Cat-scratch disease and Bacillary angiomatosis)
Rickettsia rickettsii (Rocky Mountain spotted fever) and other Rickettsia species
Anthelmintic medications
Antimalarials
Trypanosoma cruzi (Chagas disease)
Francisella tularensis (Tularemia)
Candida
Anti-mite and louse medications
Miscellaneous antifungal medications
Azoles
Cytokines
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Hyper IgM syndrome
Leukocyte adhesion deficiency
Chronic granulomatous disease
X-linked agammaglobulinemia
Wound healing
Complement deficiency
Inflammation
Pulmonary corticosteroids and mast cell inhibitors
Selective immunoglobulin A deficiency
Necrosis and apoptosis
Ischemia
Wiskott-Aldrich syndrome
Immunodeficiencies: Clinical
Non-corticosteroid immunosuppressants and immunotherapies
Intrinsic hemolytic normocytic anemia: Pathology review
Heme synthesis disorders: Pathology review
Blood groups and transfusions
Macrocytic anemia: Pathology review
Cytomegalovirus infection after transplant (NORD)
Glucocorticoids
Blood products and transfusion: Clinical
Acute intermittent porphyria
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Aplastic anemia
Sideroblastic anemia
Microcytic anemia: Pathology review
Erythropoietin
Post-transplant lymphoproliferative disorders (NORD)
Platelet disorders: Pathology review
Thrombotic thrombocytopenic purpura
Neonatal jaundice: Clinical
Jaundice: Clinical
Mixed platelet and coagulation disorders: Pathology review
Von Willebrand disease
Immune thrombocytopenia
Hemolytic-uremic syndrome
Extrinsic hemolytic normocytic anemia: Pathology review
Jaundice
Iron deficiency anemia
Anemia: Clinical
Graft-versus-host disease
Iron deficiency anemia: Clinical sciences
Autoimmune hemolytic anemia
Severe chronic neutropenia (NORD)
Anemia of chronic disease: Year of the Zebra
Jaundice: Pathology review
Blood transfusion reactions and transplant rejection: Pathology review
Anemia of chronic disease
Non-hemolytic normocytic anemia: Pathology review
Antimetabolites: Sulfonamides and trimethoprim
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Fluoroquinolones
Protein synthesis inhibitors: Aminoglycosides
Nucleotide metabolism
Adenosine deaminase deficiency
Purine and pyrimidine synthesis and metabolism disorders: Pathology review
Gout
Gout and pseudogout: Pathology review
Lesch-Nyhan syndrome
Gout: Clinical sciences
Oncogenes and tumor suppressor genes
Anti-tumor antibiotics
Blood histology
DNA synthesis inhibitors: Metronidazole
Deep vein thrombosis
Disseminated intravascular coagulation
Factor V Leiden
Protein C deficiency
Protein S deficiency
Miscellaneous cell wall synthesis inhibitors
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Antithrombin III deficiency
Heparin-induced thrombocytopenia
Antiphospholipid syndrome
Hemophilia
Hemophilia: Year of the Zebra
Protease inhibitors
Nucleoside reverse transcriptase inhibitors (NRTIs)
Hepatitis medications
HIV and AIDS: Pathology review
Thrombosis syndromes (hypercoagulability): Pathology review
Mechanisms of antibiotic resistance
Coagulation disorders: Pathology review
Integrase and entry inhibitors
Leukemias: Pathology review
Myeloproliferative disorders: Pathology review
Lymphomas: Pathology review
Chronic leukemia
Acute leukemia
Non-Hodgkin lymphoma
Polycythemia vera (NORD)
Myelodysplastic syndromes
Hodgkin lymphoma
Essential thrombocythemia (NORD)
Waldenstrom macroglobulinemia
Multiple myeloma: Clinical sciences
Mastocytosis (NORD)
Plasma cell disorders: Pathology review
Plasma cell disorders: Clinical
Spleen histology
Myelofibrosis (NORD)
Lymphoma: Clinical
Varicella zoster virus
Coxsackievirus
Congenital TORCH infections: Pathology review
Streptococcus pyogenes (Group A Strep)
Lyme disease: Clinical sciences
Cortisol
Hematopoietic medications
Parvovirus B19
HIV (AIDS)
Zika virus

Transcript

Watch video only

Wiskott-Aldrich syndrome is also called eczema-thrombocytopenia-immunodeficiency syndrome.

So, one by one, there’s eczema, also called atopic dermatitis, which is characterized by dry red patches arising on the skin.

There’s a type of thrombocytopenia called microthrombocytopenia because not only are there very few platelets, but the platelets are also small in size.

And there’s a problem with the immune system that leads to repeated infections.

All of the hematopoietic cells, which are cells in the bone marrow, produce Wiskott-Aldrich syndrome protein, or WASp for short.

There’s also a gene - called the WIPF1 gene, which encodes a protein called WAS/WASL-interacting protein family member 1, which helps stabilize Wiskott-Aldrich protein.

So WASp, aside from having a really long name that shortens down to the name of a scary flying insect - helps to reorganize the cell’s cytoskeleton, and therefore its overall shape.

The cytoskeleton can change by either adding to or removing actin proteins from the end of an actin chain.

The chain grows longer in the direction that a cell wants to move and shortens on the side that a cell wants to move away from.

This helps with various cellular activities like phagocytosis and cellular division.

Platelets specifically rely on this functionality, because they originate from large precursor cells called megakaryocytes.

This megakaryocyte has many long arms - like a squid - and the cytoskeleton changes shape so that these arms can detach to form cellular fragments called platelets.

The platelets then go off to form clots at damaged sites in the blood vessels, to stop bleeding.

Another cell type are the T-cells, which are a type of immune cell, also rely on the cytoskeleton being able to change shape.

When they encounter a pathogen, T-cells form pseudopods or false legs that reach out and synapse or communicate with other cells.

Think of it like they’re shaking hands to exchange information.

Helper T cells get activated when they form an immunological synapse with antigen presenting cells.

And once they’re activated, helper T-cells activate B-cells which generate antibodies which help destroy the pathogen.

Next up are the cytotoxic T-cells and natural killer cells, which also reorganize their cytoskeleton to form an immunological synapse with various body cells to do surveillance, and find out if they’re healthy or if they’re infected or cancerous.

If an unhealthy cell is discovered, the immune cells make that unhealthy cell undergo apoptosis, or programmed cell death.

Together, the T-cells, B-cells, and natural killer cells protect the body from pathogens as well as cancer.

There are also T-cells called regulatory T cells or T-regs, which downregulate the other T cells to limit the immune response and prevent autoimmune conditions from arising.

T-regs also rely on reorganizing their cytoskeleton to function normally. Finally, there are the phagocytic cells like monocytes, macrophages, and dendritic cells, which form small foot processes to make their way towards cytokines.

These phagocytic cells are like little bloodhounds and following a cytokine trail.

These cells also perform phagocytosis, to swallow up debris, dead cells, and bacteria, so that it can be processed and destroyed.

In Wiskott-Aldrich syndrome, a mutation in the gene results in a Wiskott-Aldrich protein that can’t function normally.

Key Takeaways

Wiskott-Aldrich syndrome (WAS) is a rare X-linked primary immunodeficiency disorder that primarily affects males. The condition is caused by mutations in the WAS gene, which encodes for the Wiskott-Aldrich syndrome protein (WASP). The signs and symptoms of Wiskott-Aldrich syndrome can vary widely, but often include recurrent infections due to a weakened immune system, eczema, easy bruising or bleeding due to decreased platelets and abnormal clotting, autoimmune disorders such as rheumatoid arthritis or autoimmune hemolytic anemia, and increased risk of developing certain types of cancer, including lymphoma and leukemia.

Sources

  1. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  2. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  3. "Yen & Jaffe's Reproductive Endocrinology" Saunders W.B. (2018)
  4. "Bates' Guide to Physical Examination and History Taking" LWW (2016)
  5. "Robbins Basic Pathology" Elsevier (2017)
  6. "Membrane grease eases platelet maturation" Blood (2015)
  7. "Mutations of the Wiskott-Aldrich Syndrome Protein (WASP): hotspots, effect on transcription, and translation and phenotype/genotype correlation" Blood (2004)
  8. "Clinical course of patients with WASP gene mutations" Blood (2004)