This is a rare, autosomal recessive disorder characterised by telangiectasia, cerebellar ataxia and immunodeficiency due to a lack of lymphoid tissue (spleen, thymus and lymph nodes). It gives rise to recurrent sinusitis, pneumonia and an increased risk of malignancy (10% develop lymphoma and leukaemia).
•  Check for congenital asplenia.

•  Check for pulmonary vascular malformations.
•  Ruptured teleangiectatic intracerebral vessels may cause intracerebral haemorrhage.


•  Check for high signal on diffusion-weighted imaging (DWI) in keeping with infarcts (emboli shunted through pulmonary arteriovenous malformations [AVMs]).
 Expect a small cerebellum with atrophy of the anterior vermis and compensatory enlargement of the fourth ventricle.


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