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Shakya S, Maheshwari A, Divya K, Katti BR, R A, Mahto D. X-Linked Agammaglobulinemia with Kawasaki Disease. Indian J Pediatr 2022; 89:413. [PMID: 35013980 DOI: 10.1007/s12098-021-04058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Sakshi Shakya
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India
| | - Anu Maheshwari
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India.
| | - Kakarla Divya
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India
| | - Bharat Ravi Katti
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India
| | - Ackshaya R
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India
| | - Deonath Mahto
- Department of Pediatrics, Lady Hardinge Medical College and assosciated Kalawati Saran Children Hospital, New Delhi, 110001, India
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Qing-Qi R, Ya-Wen L, Huan C, Yu Z, Yun-Fei A, Xue-Mei T, Xiao-Dong Z, Zhi-Yong Z. Retrospective study of 98 patients with X-linked agammaglobulinemia complicated with arthritis. Clin Rheumatol 2022; 41:1889-1897. [PMID: 35171366 DOI: 10.1007/s10067-022-06095-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/19/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We preformed this retrospective study of clinical manifestation, imaging feature, and mutations to describe joint involvement in X-linked agammaglobulinemia (XLA) patients, aimed to provide recommendation for physicians. METHODS A total number of 98 XLA patients who have been diagnosed between January 2000 and February 2020 were enrolled and grouped based on whether they developed arthritis and analyzed for the clinical, imaging, and gene mutation data using the t test or the Mann-Whitney test. RESULTS Forty-five out of 98 patients (45.9%) had joint involvement, 40.8% had symptom prior to the diagnosis of XLA, and 54.1% had no articular symptom. Patients with joint involvement had a higher median diagnostic age of XLA and initial IgG level than patients without it, while their intravenous immunoglobulin was lower (p < 0.05). Knee, hip, and ankle were the most frequent joint, and oligoarthritis (≦ 4 joints) was more common than polyarthritis (88.9% vs 11.1%). Red and tenderness were the most frequent clinical symptoms (80%) with 24.4% reporting limited activity and 8.9% reporting deformity. Imaging data collected from 32 patients indicated that joint effusion (53.3%), synovitis (15.5%), and swollen soft tissue (15.5%) were the most common feature. Seventeen patients were treated by antibiotics plus intravenous immunoglobulin (IVIG) with an effective rate of 70.6%, and 28 patients only received IVIG with an effective rate of 67.9%. In comparison to patients without arthritis who have higher frequency nonsense and frameshift mutation, patients with arthritis had a higher incidence of missense mutation (p < 0.05). CONCLUSION High prevalence of arthritis among X-linked agammaglobulinemia patients and subsequent progression through IVIG replacement therapy highlight the importance of timely diagnosis and better management of these patients. Our finding indicated a potential correlation between genotype and phenotype, and further research on the mechanism of arthritis in XLA patients could increase physicians' awareness and improve patients' prognosis. Key Points • This study described the feature of arthritis in XLA patients and indicated a potential correlation between this complication and genotype.
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Affiliation(s)
- Ran Qing-Qi
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China
| | - Li Ya-Wen
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China
| | - Chen Huan
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China
| | - Zhang Yu
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, 40015, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 40015, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 40015, China.,Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, 40015, China
| | - An Yun-Fei
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, 40015, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 40015, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 40015, China.,Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, 40015, China
| | - Tang Xue-Mei
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, 40015, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 40015, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 40015, China.,Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, 40015, China
| | - Zhao Xiao-Dong
- National Clinical Research Center for Child Health and Disorders, Chongqing, 40015, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 40015, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 40015, China.,Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, 40015, China.,The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
| | - Zhang Zhi-Yong
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, 400015, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, 40015, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 40015, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 40015, China.,Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, 40015, China
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Costagliola G, Cappelli S, Consolini R. Autoimmunity in Primary Immunodeficiency Disorders: An Updated Review on Pathogenic and Clinical Implications. J Clin Med 2021; 10:jcm10204729. [PMID: 34682853 PMCID: PMC8538991 DOI: 10.3390/jcm10204729] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022] Open
Abstract
During the last years, studies investigating the intriguing association between immunodeficiency and autoimmunity led to the discovery of new monogenic disorders, the improvement in the knowledge of the pathogenesis of autoimmunity, and the introduction of targeted treatments. Autoimmunity is observed with particular frequency in patients with primary antibody deficiencies, such as common variable immunodeficiency (CVID) and selective IgA deficiency, but combined immunodeficiency disorders (CIDs) and disorders of innate immunity have also been associated with autoimmunity. Among CIDs, the highest incidence of autoimmunity is described in patients with autoimmune polyendocrine syndrome 1, LRBA, and CTLA-4 deficiency, and in patients with STAT-related disorders. The pathogenesis of autoimmunity in patients with immunodeficiency is far to be fully elucidated. However, altered germ center reactions, impaired central and peripheral lymphocyte negative selection, uncontrolled lymphocyte proliferation, ineffective cytoskeletal function, innate immune defects, and defective clearance of the infectious agents play an important role. In this paper, we review the main immunodeficiencies associated with autoimmunity, focusing on the pathogenic mechanisms responsible for autoimmunity in each condition and on the therapeutic strategies. Moreover, we provide a diagnostic algorithm for the diagnosis of PIDs in patients with autoimmunity.
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Swee DS, Spickett G, Quinton R. Many women with Turner syndrome lack protective antibodies to common respiratory pathogens, Haemophilus influenzae type B and Streptococcus Pneumoniae. Clin Endocrinol (Oxf) 2019; 91:228-230. [PMID: 30916795 DOI: 10.1111/cen.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/14/2019] [Accepted: 03/22/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Du Soon Swee
- Department of Endocrinology, Newcastle-upon-Tyne Hospitals, Newcastle Upon Tyne, UK
- Department of Endocrinology, Singapore General Hospital, Singapore
| | - Gavin Spickett
- Clinical Immunology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Richard Quinton
- Department of Endocrinology, Newcastle-upon-Tyne Hospitals, Newcastle Upon Tyne, UK
- Institute of Genetic Medicine, University of Newcastle-upon-Tyne, Newcastle upon Tyne, UK
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Azizi G, Tavakol M, Rafiemanesh H, Kiaee F, Yazdani R, Heydari A, Abouhamzeh K, Anvari P, Mohammadikhajehdehi S, Sharifia L, Bagheri Y, Mohammadi H, Abolhassani H, Aghamohammadi A. Autoimmunity in a cohort of 471 patients with primary antibody deficiencies. Expert Rev Clin Immunol 2017; 13:1099-1106. [DOI: 10.1080/1744666x.2017.1384312] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Laboratory Medicine, Imam Hassan Mojtaba Hospital, Alborz University of Medical Sciences, Karaj, Iran
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Marzieh Tavakol
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Allergy and Clinical Immunology, Shahid Bahonar Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Hosein Rafiemanesh
- Students’ Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Kiaee
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Heydari
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kosar Abouhamzeh
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Anvari
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mohammadikhajehdehi
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Laleh Sharifia
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasser Bagheri
- Student Research Committee, Golstan University of Medical Sciences, Gorgan, Iran
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Abolhassani
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Asghar Aghamohammadi
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Chen N, Zhang ZY, Liu DW, Liu W, Tang XM, Zhao XD. The clinical features of autoimmunity in 53 patients with Wiskott-Aldrich syndrome in China: a single-center study. Eur J Pediatr 2015; 174:1311-8. [PMID: 25877044 DOI: 10.1007/s00431-015-2527-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 12/29/2022]
Abstract
UNLABELLED Autoimmune disease (AD) is common in patients with Wiskott-Aldrich syndrome (WAS) and patients with WAS who has an AD usually constitute a high-risk group with poor outcome. However, knowledge of AD in WAS is limited in China. In this study, medical records of 53 patients with WAS at Children´s Hospital of Chongqing Medical University from April 2004 to January 2014 were evaluated retrospectively and 14 patients (26%) had at least one AD. Autoimmune hemolytic anemia (AIHA) was the most common and detected in 12 patients (23%), other complications included immune thrombocytopenia (n = 1), immune neutropenia (n = 1), autoimmune arthritis (n = 1), and renal injury (n = 1). No significant differences were found in the level of serum immunoglobulins and lymphocyte subsets between the AD group and non-AD group. Although eight patients with AD received hematopoietic stem cell transplantation (HSCT), three patients died of pulmonary infection after HSCT. CONCLUSIONS AD is frequent in Chinese patients with WAS and AIHA was the most common. AD is a poor prognosis factor for WAS and should be treated as early as possible by HSCT. WHAT IS KNOWN • Autoimmune disease is common in patients with WAS. • Manifestations, follow-up finding, and treatment approaches of autoimmune disease in Chinese patients with WAS have received less attention in the literature. What is New: • This study is firstly intended for evaluation of the clinical and immune characteristics of autoimmune disease in a large series Chinese patients with WAS. • AD is frequent in Chinese patients with WAS and AIHA is the most common.
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Affiliation(s)
- Nan Chen
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Zhi-Yong Zhang
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Da-Wei Liu
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Wei Liu
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Xue-Mei Tang
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Xiao-Dong Zhao
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
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Behniafard N, Aghamohammadi A, Abolhassani H, Pourjabbar S, Sabouni F, Rezaei N. Autoimmunity in X-linked agammaglobulinemia: Kawasaki disease and review of the literature. Expert Rev Clin Immunol 2014; 8:155-9. [DOI: 10.1586/eci.11.94] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Lim LM, Chang JM, Wang IF, Chang WC, Hwang DY, Chen HC. Atypical X-linked agammaglobulinaemia caused by a novel BTK mutation in a selective immunoglobulin M deficiency patient. BMC Pediatr 2013; 13:150. [PMID: 24074005 PMCID: PMC3849551 DOI: 10.1186/1471-2431-13-150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 09/24/2013] [Indexed: 01/13/2023] Open
Abstract
Background X-linked agammaglobulinaemia (XLA) is the most common inherited humoural immunodeficiency disorder. Mutations in the gene coding for Bruton’s tyrosine kinase (BTK) have been identified as the cause of XLA. Most affected patients exhibit a marked reduction of serum immunoglobulins, mature B cells, and an increased susceptibility to recurrent bacterial infections. However, the diagnosis of XLA can be a challenge in certain patients who have near-normal levels of serum immunoglobulin. Furthermore, reports on XLA with renal involvement are scant. Case presentation We report an atypical XLA patient who presented with selective immunoglobulin M (IgM) immunodeficiency and nephropathy. He was diagnosed with selective IgM immunodeficiency, based on his normal serum immunoglobulin G (IgG) and immunoglobulin A (IgA) levels but undetectable serum IgM level. Intravenous immunoglobulin was initiated due to increased infections and persistent proteinuria but no improvement in proteinuria was found. A lupus-like nephritis was detected in his kidney biopsy and the proteinuria subsided after receiving a mycophenolate mofetil regimen. Although he had a history of recurrent bacterial infections since childhood, XLA was not diagnosed until B-lymphocyte surface antigen studies and a genetic analysis were conducted. Conclusions We suggest that B-lymphocyte surface antigen studies and a BTK mutation analysis should be performed in familial patients with selective IgM deficiency to rule out atypical XLA.
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Affiliation(s)
- Lee-Moay Lim
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tze-You First Road, Kaohsiung City 807, Taiwan.
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Schwarz JM, Bilbo SD. Sex, glia, and development: interactions in health and disease. Horm Behav 2012; 62:243-53. [PMID: 22387107 PMCID: PMC3374064 DOI: 10.1016/j.yhbeh.2012.02.018] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 12/14/2022]
Abstract
Microglia and astrocytes are the primary immune cells within the central nervous system. Microglia influence processes including neural development, synaptic plasticity and cognition; while their activation and production of immune molecules can induce stereotyped sickness behaviors or pathologies including cognitive dysfunction. Given their role in health and disease, we propose that glia may also be a critical link in understanding the etiology of many neuropsychiatric disorders that present with a strong sex-bias in their symptoms or prevalence. Specifically, males are more likely to be diagnosed with disorders that have distinct developmental origins such as autism or schizophrenia. In contrast, females are more likely to be diagnosed with disorders that present later in life, after the onset of adolescence, such as depression and anxiety disorders. In this review we will summarize the evidence suggesting that sex differences in the colonization and function of glia within the normal developing brain may contribute to distinct windows of vulnerability between males and females. We will also highlight the current gaps in our knowledge as well as the future directions and considerations of research aimed at understanding the link between neuroimmune function and sex differences in mental health disorders.
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Affiliation(s)
- Jaclyn M Schwarz
- Department of Psychology and Neuroscience, Duke University, 572 Research Dr. Rm 3017, Durham, NC 27705, USA.
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Sex differences and genomics in autoimmune diseases. J Autoimmun 2012; 38:J254-65. [DOI: 10.1016/j.jaut.2011.12.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 12/02/2011] [Indexed: 12/23/2022]
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