Rethinking RASGRP1: A Malaysian Girl's Journey with Kidney Disease and Lymphoma

A young girl facing two rare health problems in her early years. At just 5 months old, she was diagnosed with a condition called diffuse mesangial sclerosis, a rare cause of severe kidney issues in infants. Fast forward to age 3, she started experiencing swollen lymph nodes in her neck that never went away. Doctors were puzzled by her complex medical history, which included frequent infections and an unusual immune system. It turned out she had a genetic condition called RASGRP1 deficiency.This condition affects the immune system and can lead to serious problems, like chronic infection with the Epstein-Barr virus and even a type of cancer called Hodgkin lymphoma. The girl inherited this condition from both her parents, who carried a specific genetic variant. This case is special because it's the first time RASGRP1 deficiency has been reported in Malaysia, showing how diverse and challenging rare diseases can be to diagnose and manage.