Genomic newborn screening: ICoNS
Gene: ZAP70
Discussed at Gene List Subcommittee meeting on 10th February 2025: agreed appropriate for inclusion.
Note a founder variant in this gene is routinely included in NBS in Canada.Created: 10 Feb 2026, 6:21 a.m. | Last Modified: 10 Feb 2026, 6:21 a.m.
Panel Version: 0.28
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Immunodeficiency MIM#176947
• Gene disease association evidence
• Curation by ClinGen
• Treatability and evidence behind that including impact of treatment
• Issues with genomic screening (exome/genome/pseudogene etc)
• Any variants of interest
• Who has excluded it and why
• Traditional newborn screening in any jurisdiction
Strong gene disease association: definitive by ClinGen 2022
Immunodeficiency characterized by selective T-cell defect
Childhood onset, severe (death prior to 2 without treatment)
Treatment:
Supportive care includes immediate intravenous immunoglobulin (IVIG) and antibacterial, antifungal, antiviral, and Pneumocystis jiroveci prophylaxis to control and reduce the occurrence of infections.
Allogeneic HSCT to reconstitute the immune system, preferably prior to the onset of infections.
Prevention of secondary complications: Use of irradiated, leukoreduced, cytomegalovirus (CMV)-safe blood products; deferment of immunizations until immune reconstitution; consideration for formula feeds in place of breast feeding until CMV status of mother is known.
Symptoms include recurrent infections, including severe lower respiratory infections and oral candidiasis, chronic diarrhea, and failure to thrive. Combined immunodeficiencies such as ZAP-70 deficiency or major histocompatibility complex (MHC) class I and II gene expression deficiency may not be detected with the TREC assay as T-cell development is intact beyond the point of T-cell receptor (TCR) gene recombination (PMID: 32579701)
Excluded by BeginNGS? treatability ?now included (on Rx Genes)
Sources: Expert ListCreated: 9 Feb 2026, 9:51 p.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Immunodeficiency MIM#176947
Publications
Gene: zap70 has been classified as Green List (High Evidence).
Gene: zap70 has been classified as Green List (High Evidence).
gene: ZAP70 was added gene: ZAP70 was added to Genomic newborn screening: ICoNS. Sources: Expert List Mode of inheritance for gene: ZAP70 was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: ZAP70 were set to PMID: 20301777; 32579701 Phenotypes for gene: ZAP70 were set to Immunodeficiency MIM#176947 Review for gene: ZAP70 was set to GREEN