Noninfectious Complications in B-Lymphopenic Common Variable Immunodeficiency

被引:4
|
作者
Pashangzadeh, S. [1 ]
Delavari, S. [1 ,2 ]
Shad, T. Moeini [1 ]
Salami, F. [1 ,2 ]
Rasouli, S. E. [1 ,3 ]
Yazdani, R. [1 ]
Mahdaviani, S. A. [4 ]
Nabavi, M. [5 ]
Aleyasin, S. [6 ]
Ahanchian, H. [7 ]
Jabbari-Azad, F. [7 ]
Chavoshzadeh, Z. [8 ]
Nazari, F. [1 ]
Momen, T. [9 ]
Sherkat, R. [10 ]
Abolnezhadian, F. [11 ]
Esmaeilzadeh, H. [6 ]
Fallahpour, M. [6 ]
Arshi, S. [5 ]
Bemanian, M. H. [5 ]
Shokri, S. [5 ]
Ebrahimi, S. S. [12 ]
Abolmolouki, M. [1 ]
Farid, A. S. [1 ]
Rezaei, A. [1 ]
Esmaeili, M. [1 ,2 ]
Kalantari, A. [13 ]
Sadeghi-Shabestari, M. [14 ]
Shirkani, A. [15 ]
Behniafard, N. [16 ]
Khalili, A. [17 ]
Eslamian, M. H. [18 ]
Cheraghi, T. [19 ]
Shafie, A. [20 ]
Tavakol, M. [3 ]
Khoshkhui, M. [7 ]
Iranparast, S. [21 ]
Shamshiri, M. [21 ]
Shahri, M. A. [1 ]
Khazaei, R. [11 ]
Asadi, M. [1 ]
Babaha, F. [1 ]
Aghamohammadi, A. [1 ]
Rezaei, N. [1 ,2 ]
Abolhassani, H. [1 ,22 ]
机构
[1] Univ Tehran Med Sci, Res Ctr Immunodeficiencies, Pediat Ctr Excellence, Childrens Med Ctr, Tehran, Iran
[2] Universal Sci Educ & Res Network USERN, Primary Immunodeficiency Dis Network PIDNet, Tehran, Iran
[3] Alborz Univ Med Sci, Noncommunicable Dis Res Ctr, Karaj, Iran
[4] Shahid Beheshti Univ Med Sci, Natl Res Inst TB & Lung Dis NRITLD, Pediat Resp Dis Res Ctr, Tehran, Iran
[5] Iran Univ Med Sci, Rasool E Akram Hosp, Dept Allergy & Clin Immunol, Tehran, Iran
[6] Shiraz Univ Med Sci, Allergy Res Ctr, Shiraz, Iran
[7] Mashhad Univ Med Sci, Allergy Res Ctr, Mashhad, Iran
[8] Shahid Beheshti Univ Med Sci, Mofid Childrens Hosp, Pediat Infect Res Ctr, Tehran, Iran
[9] Isfahan Univ Med Sci, Res Inst Primordial Prevent Noncommunicable Dis, Dept Allergy & Clin Immunol, Child Growth & Dev Res Ctr, Esfahan, Iran
[10] Isfahan Univ Med Sci, Immunodeficiency Dis Res Ctr, Esfahan, Iran
[11] Ahvaz Jundishapur Univ Med Sci, Abuzar Childrens Hosp, Dept Pediat, Ahvaz, Iran
[12] Kerman Univ Med Sci, Dept Immunol & Allergy, Kerman, Iran
[13] Univ Tehran Med Sci, Imam Khomeini Hosp, Dept Immunol & Allergy, Tehran, Iran
[14] Tabriz Univ Med Sci, Dept Immunol & Allergy, Tabriz, Iran
[15] Bushehr Univ Med Sci, Sch Med, Allergy & Clin Immunol Dept, Bushehr, Iran
[16] Shahid Sadoughi Univ Med Sci, Children Growth Disorder Res Ctr, Yazd, Iran
[17] Shahid Sadoughi Univ Med Sci, Dept Pediat, Yazd, Iran
[18] Hamedan Univ Med Sci, Dept Pediat, Hamadan, Iran
[19] Guilan Univ Med Sci, 17 Shahrivar Childrens Hosp, Dept Pediat, Rasht, Iran
[20] Univ Tehran Med Sci, Bahrami Hosp, Dept Immunol, Tehran, Iran
[21] Ahvaz Jundishapur Univ Med Sci, Fac Med, Dept Immunol, Ahvaz, Iran
[22] Karolinska Inst, Dept Med Biochem & Biophys, Div Immunol, Stockholm, Sweden
关键词
Primary immunodeficiency; Inborn errors of immunity; Common variable immunodeficiency.Autoimmunity; immunodeficiency.Autoimmunity; Malignancy; Immune dysregulation; REGULATORY T-CELLS; IGA DEFICIENCY; AUTOIMMUNITY; DISORDERS; SUBSETS; COHORT; LYMPHOCYTES; PHENOTYPE; CHILDREN; CRITERIA;
D O I
10.18176/jiaci.0902
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Common variable immunodeficiency (CVID) is considered the most symptomatic type of inborn errors of immunity in humans. Along with infectious complications, which have numerous consequences, noninfectious complications are a major challenge among CVID patients. Methods: All CVID patients registered in the national database were included in this retrospective cohort study. Patients were divided into 2 groups based on the presence of B-cell lymphopenia. Demographic characteristics, laboratory findings, noninfectious organ involvement, autoimmunity, and lymphoproliferative diseases were evaluated. Results: Among 387 enrolled patients, 66.4% were diagnosed with noninfectious complications and 33.6% with isolated infectious presentations. Enteropathy, autoimmunity, and lymphoproliferative disorders were reported in 35.1%, 24.3%, and 21.4% of patients, respectively. Some complications, including autoimmunity and hepatosplenomegaly, were reported to be significantly more frequent among patients with B-cell lymphopenia. As for organ involvement, the dermatologic, endocrine, and musculoskeletal systems were predominantly affected in CVID patients with B-cell lymphopenia. Among autoimmune manifestations, the frequency of rheumatologic, hematologic, and gastrointestinal autoimmunity was reported to be higher than that of other types of autoimmunity not associated with B cell-lymphopenia. Furthermore, hematological cancers, particularly lymphoma, were the most common type of malignancy. The mortality rate was 24.5%, and respiratory failure and malignancies were the most common causes of death, with no significant differences between the 2 groups. Conclusion: Considering that some of the noninfectious complications might be associated with B-cell lymphopenia, regular patient monitoring and follow-up with proper medication (in addition to immunoglobulin replacement therapy) are highly recommended to prevent sequelae and increase patient quality of life.
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收藏
页码:233 / 245
页数:13
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