Given the susceptibility of MIRAGE syndrome patients to infection, the interferon inducible nature of SAMD9, and the survival advantage of monosomy 7 in the setting of MIRAGE syndrome, it has been speculated that recurring infections can be a driving force in promoting exacerbation of MIRAGE syndrome, subsequent revertant mosaicism, and the precipitation of monosomy 7 associated MDS [19]. Here, SAMD9 is linked to MIRAGE syndrome.