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Severe Combined Immunodeficiency

SCID – Artemis (DCLRE1C Deficiency)

A radiosensitive form of Severe Combined Immunodeficiency caused by mutations in DCLRE1C, leaving infants without functional T and B lymphocytes and at risk of life-threatening infection from the first months of life.

  • Radiosensitive SCID Subtype
  • Newborn Screening Detectable
  • Curative HSCT or Gene Therapy Pathway
Typical Onset
Birth to Early Infancy
Inheritance Pattern
Autosomal Recessive
Key Gene
DCLRE1C (Artemis)
Detected By
Newborn Screening (TREC Assay)

Condition Overview

SCID due to Artemis deficiency is caused by mutations in the DCLRE1C gene, which encodes a protein essential for repairing DNA breaks created during the normal process of assembling T and B cell antigen receptors. Without functional Artemis protein, developing T and B lymphocytes cannot complete this process and the immune system fails to develop normally.

This is classified as a radiosensitive SCID because cells from affected infants are also more sensitive to radiation-induced DNA damage generally, which has specific implications for treatment planning, particularly around the intensity of pre-transplant conditioning regimens.

Like other forms of SCID, Artemis deficiency is a pediatric emergency. Affected infants appear healthy at birth but develop severe, recurrent, and often opportunistic infections within the first months of life. Newborn screening using the T-cell receptor excision circle (TREC) assay has made earlier detection possible in many regions, often before symptoms appear.

Types and Subtypes

Artemis-deficient SCID is one of several genetic causes of SCID and is grouped immunologically with other forms that share an absence of T and B lymphocytes but preserved natural killer cells.

Symptoms and Signs

Infants with Artemis-deficient SCID appear healthy at birth but typically develop severe symptoms within the first few months of life if not identified by newborn screening.

Causes and Risk Factors

Artemis-deficient SCID is caused by inherited mutations in the DCLRE1C gene that impair V(D)J recombination, the process that generates diverse T and B cell receptors.

Diagnosis and Investigations

Diagnosis often begins with newborn screening and proceeds through immune phenotyping and genetic confirmation.

Disease Severity and Risk Stratification

SCID does not use a tumor-style staging system. Risk stratification instead reflects infection status and timing of diagnosis relative to transplant, both of which strongly influence outcomes.

Standard Treatment Options

Treatment focuses on preventing infection while moving as quickly as possible toward curative hematopoietic stem cell transplantation, with conditioning regimens adjusted for radiosensitivity.

Advanced & Emerging Therapies

Both transplant and emerging gene therapy approaches are relevant to Artemis-deficient SCID, with conditioning strategy tailored to the radiosensitive nature of this subtype.

  • Cellular Therapy

    Allogeneic Hematopoietic Stem Cell Transplantation

    The established curative approach; conditioning intensity is individualized given known radiosensitivity.

    Available
  • Cellular Therapy

    Reduced-Toxicity Conditioning Regimens

    Increasingly used in radiosensitive SCID subtypes to lower transplant-related toxicity while preserving engraftment success.

    Available
  • Gene Therapy

    Investigational Autologous Gene Therapy

    Gene therapy approaches are an active area of research for several SCID subtypes; availability for Artemis-deficient SCID specifically should be confirmed with a specialist center.

    Investigational

Biomarkers & Precision Medicine

Immune and genetic markers guide diagnosis, transplant planning, and monitoring of immune recovery.

When a Second Opinion May Be Important

Given the time-sensitive nature of SCID and the specific conditioning considerations in Artemis deficiency, specialist input early in the course is particularly valuable.

Clinical Trials & Research

Prognosis & Outcome Factors

Outcomes in Artemis-deficient SCID depend strongly on how early the diagnosis is made, often through newborn screening, and whether transplant occurs before serious infection develops.

Supportive Care and Living with Artemis-Deficient SCID

Supportive care protects the infant from infection while definitive treatment is arranged and supports recovery afterward.

How CancerFax Helps You Explore Treatment Options

CancerFax helps families of infants with Artemis-deficient SCID obtain urgent specialist immunology report review, coordinate second opinions, and connect with hospitals experienced in radiosensitive SCID transplant, including cross-border care coordination where relevant.

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Frequently Asked Questions

It is a form of Severe Combined Immunodeficiency caused by mutations in the DCLRE1C gene, which leaves infants without functional T and B lymphocytes from early infancy.

Exploring Care Options for SCID – Artemis (DCLRE1C)?

Send your medical reports for specialist review and connect with centers experienced in primary immunodeficiency and inherited metabolic-inflammatory disease management.