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Rodriguez KM, Vaught J, Dilley M, Ellsworth K, Heinen A, Abud EM, Zhang Y, Smith RJH, Sheets R, Geng B, Hoffman HM, Worthen HM, Dimmock D, Coufal NG. Rapid genome sequencing identifies novel variants in complement factor I. Cold Spring Harb Mol Case Stud 2022; 8:a006239. [PMID: 36577522 PMCID: PMC9808552 DOI: 10.1101/mcs.a006239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/05/2022] [Indexed: 12/30/2022] Open
Abstract
Complement factor I deficiency (CFID; OMIM #610984) is a rare immunodeficiency caused by deficiencies in the serine protease complement factor I (CFI). CFID is characterized by predisposition to severe pneumococcal infection, often in infancy. We report a previously healthy adolescent male who presented with respiratory failure secondary to pneumococcal pneumonia and severe systemic inflammatory response. Rapid genome sequencing (rGS) identified compound heterozygous variants in CFI in the proband, with a novel maternally inherited likely pathogenic variant, a single nucleotide deletion resulting in premature stop (c.1646del; p.Asn549ThrfsTer25) and a paternally inherited novel likely pathogenic deletion (Chr 4:110685580-110692197del).
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Affiliation(s)
- Katherine M Rodriguez
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Pediatric Critical Care, Department of Pediatrics, University of California at San Diego, San Diego, California 92123, USA
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Jordan Vaught
- Rady Children's Hospital, San Diego, California 92123, USA
- Department of Pediatrics, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
| | - Michelle Dilley
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
| | - Kataryzna Ellsworth
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Alaina Heinen
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Edsel M Abud
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
- Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, California 92093, USA
| | - Yuzhou Zhang
- Molecular Otolaryngology and Renal Research Laboratories, University of Iowa, Iowa City, Iowa 52242, USA
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories, University of Iowa, Iowa City, Iowa 52242, USA
| | - Robert Sheets
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
| | - Bob Geng
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
| | - Hal M Hoffman
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California at San Diego, San Diego, California 92161, USA
| | - H Michael Worthen
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Pediatric Critical Care, Department of Pediatrics, University of California at San Diego, San Diego, California 92123, USA
| | - David Dimmock
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Nicole G Coufal
- Rady Children's Hospital, San Diego, California 92123, USA
- Division of Pediatric Critical Care, Department of Pediatrics, University of California at San Diego, San Diego, California 92123, USA
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
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Dilley M, Geng B. Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole. Clin Rev Allergy Immunol 2021; 62:463-475. [PMID: 34910281 PMCID: PMC9156451 DOI: 10.1007/s12016-021-08878-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/02/2022]
Abstract
Hypersensitivity reactions including IgE-mediated and delayed cell-mediated reactions to aminoglycosides, clindamycin, linezolid, and metronidazole are rare. For aminoglycosides, allergic contact dermatitis is the most frequent reaction for which patch testing can be a useful step in evaluation. For clindamycin, delayed maculopapular exanthems are the most common reactions. There are case reports of clindamycin associated with drug rash with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), acute febrile neutrophilic dermatosis, and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). For linezolid, cases of hypersensitivity were exceedingly rare and included urticaria, angioedema, anaphylaxis, delayed rashes, and DRESS. For metronidazole, only rare cases were found across a broad spectrum of reactions including allergic contact dermatitis, fixed drug eruption, angioedema, anaphylaxis, serum sickness-like reaction, SJS/TEN, AGEP, SDRIFE, and a possible case of DRESS. IgE-mediated reactions and anaphylaxis to these types of antibiotics are uncommon, and reports of skin testing concentrations and desensitization protocols are largely limited to case reports and series. Non-irritating skin testing concentrations have been reported for gentamycin, tobramycin, and clindamycin. Published desensitization protocols for intravenous and inhaled tobramycin, oral clindamycin, intravenous linezolid, and oral and intravenous metronidazole have also been reported and are reviewed.
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Affiliation(s)
- Michelle Dilley
- University of California San Diego and Rady Children's Hospital, San Diego, CA, USA.
| | - Bob Geng
- University of California San Diego and Rady Children's Hospital, San Diego, CA, USA
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Abstract
PURPOSE OF REVIEW There is an emerging body of research on targeted biologic therapies for the treatment of severe inflammatory nasal disorders, especially chronic rhinosinusitis with nasal polyposis (CRSwNP). This paper will evaluate the efficacy of biologic therapies for severe nasal inflammation by summarizing key preclinical trials of biologics for animal models of allergic rhinitis and the recent phase 2 and 3 clinical trials of biologic therapies for CRSwNP. RECENT FINDINGS Biologics that target the IL-4 receptor (dupilumab), IgE (omalizumab), and IL-5 (mepolizumab, reslizumab, and benralizumab) in patients with CRSwNP have shown improvement of various metrics including Sino-Nasal Outcome Test (SNOT-22) scores, Nasal Polyp Scores (NPS), Nasal Congestion Scores (NCS), and Lund-Mackay sinus opacification scores. The efficacy demonstrated through the dupilumab phase 3 trials (LIBERTY NP SINUS-24 and SINUS-52) led to approval of the first biologic for the treatment of CRSwNP. Phase 3 trials for omalizumab (POLYP 1 and 2) and mepolizumab (SYNAPSE study) and post hoc analyses of phase 3 asthma studies for reslizumab and benralizumab have also demonstrated positive results for the use of biologics for patients with CRSwNP. Future efficacy studies and risk/benefit and cost analyses of these biologics and other cytokine targets for allergic rhinitis with and without nasal polyposis need to be performed.
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Affiliation(s)
- Bob Geng
- University of California San Diego and Rady Children's Hospital, San Diego, CA, USA.
| | - Michelle Dilley
- University of California San Diego and Rady Children's Hospital, San Diego, CA, USA
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Abstract
Background: Primary immunodeficiency diseases (PIDD) consist of a heterogeneous group of disorders characterized by various aspects of immune dysregulation. Although the most universally recognized manifestation of PIDD is an increased susceptibility to infections, there is a growing body of evidence that patients with PIDD often have a higher incidence of lung disease, autoimmunity, autoinflammatory disorders, and malignancy. Objective: The purpose of this study was to better understand the noninfectious complications of PIDD by determining the comorbid disease prevalence across various age groups, genders, and immunoglobulin replacement types compared with the general population. Methods: A large U.S. insurance claims database was retrospectively analyzed for patients who had a diagnosis of PIDD and who had received intravenous immunoglobulin (IVIG) or subcutaneous immunoglobulin (SCIG). The prevalences of 31 different comorbid conditions in the Elixhauser comorbidity index were compared among the 3125 patients in the PIDD population to > 37 million controls separated by gender and by 10-year age cohorts. Results: In the PIDD population, statistically significantly higher comorbid diagnoses included chronic obstructive pulmonary disease-asthma in 51.5%, rheumatoid disease in 14%, deficiency anemia in 11.8%, hypothyroidism in 21.2%, lymphoma in 16.7%, neurologic disorders in 9.7%, arrhythmias in 19.9%, electrolyte disorders in 23.6%, coagulopathies in 16.9%, and weight loss in 8.4%. Conclusion: PIDD that require immunoglobulin replacement are associated with an increased risk of numerous comorbid conditions that affect morbidity and mortality. Recognition and increased awareness of these noninfectious complications can allow for better monitoring, care coordination, targeted treatments, and improved prognosis.
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Affiliation(s)
- Michelle Dilley
- From the Division of Allergy, Immunology and Rheumatology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Hannah Wangberg
- From the Division of Allergy, Immunology and Rheumatology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Joshua Noone
- Department of Public Health Sciences, University of North Carolina, Charlotte, North Carolina
| | - Bob Geng
- From the Division of Allergy, Immunology and Rheumatology, University of California San Diego and Rady Children's Hospital, San Diego, California
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Dilley M, Mason K, Silverman D, Quach J, Beigi M, Ringman J, Cummings J, Grill J. P1‐171: Ketogenic medical food consumption in Alzheimer's disease enhances the acute cerebral blood flow response in specific frontocortical and basal ganglia regions. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | - Joanna Quach
- UCLA Easton Alzheimer's Disease Research CenterLos AngelesCaliforniaUnited States
| | - Maryam Beigi
- UCLA Easton Alzheimer's Disease Research CenterLos AngelesCaliforniaUnited States
| | | | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain HealthLas VegasNevadaUnited States
| | - Joshua Grill
- UCLA Easton Alzheimer's Disease Research CenterLos AngelesCaliforniaUnited States
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Abstract
The connection between El Niño/Southern Oscillation (ENSO) events and precipitation and temperature variability worldwide is increasingly well understood. ENSO has been linked to droughts and flooding in some regions. This paper uses the disaster history database of the U.S. Agency for International Development's Office of U.S. Foreign Disaster Assistance to examine the link between ENSO events and droughts or floods of sufficient magnitude to trigger international disasters. Worldwide, disasters triggered by droughts are twice as frequent during year two of ENSO warm events than during other years. No such relationship is apparent in the case of flood disasters. Drought disasters occur during year two of ENSO warm events significantly more frequently than in other years in Southern Africa and Southeast Asia. No regional pattern emerges from a comparable analysis of flood disasters. Those places likely to be affected by ENSO-triggered droughts can take proactive measures to mitigate the impacts.
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Goodman S, Gamble JG, Dilley M. Hip motion changes in hemophilia. J Pediatr Orthop 1987; 7:664-6. [PMID: 3429650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We reviewed early and late motion changes of the hip in 102 hemophiliacs with a mean follow-up of 7 years. Sixty patients (59%) had at least one hip bleed. Sixty-four hips in 49 patients demonstrated at least a 15 degree change in range of motion (ROM) at some time. At final review, only 34 of these 64 hips (53%) lost motion. Patients whose hips lost motion were just as likely to report hip bleeds as those who lost no motion. Twenty hips examined within 2 months of bleeding lost significant motion, but most motion returned within a year. The relationship between hip girdle bleeding and ROM remains obscure.
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Affiliation(s)
- S Goodman
- Stanford University Medical Center, Palo Alto, California
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