A novel Bruton's tyrosine kinase gene (BTK) missense mutation in a Chinese family with X-linked agammaglobulinemia

Guardians of Immunity: Advances in Primary Immunodeficiency Disorders and Management

Primary immunodeficiency disorders (PIDs) are a heterogeneous group of genetic conditions profoundly impacting immune function. The investigation spans various PID categories, offering insights into their distinct pathogenic mechanisms and clinical manifestations. Within the adaptive immune system, B-cell, T-cell, and combined immunodeficiencies are dissected, emphasizing their critical roles in orchestrating effective immune responses. In the realm of the innate immune system, focus is directed toward phagocytes and complement deficiencies, underscoring the pivotal roles of these components in initial defense against infections. Furthermore, the review delves into disorders of immune dysregulation, encompassing hemophagocytic lymphohistiocytosis (HLH), autoimmune lymphoproliferative syndrome (ALPS), immune dysregulation, polyendocrinopathy, enteropathy, and X-linked(IPEX), and autoimmunity polyendocrinopathy candidiasis-ectodermal dystrophy(APECED), elucidating the intricate interplay between immune tolerance and autoimmunity prevention. Diagnostic strategies for PIDs are explored, highlighting advancements in genetic and molecular techniques that enable precise identification of underlying genetic mutations and alterations in immune function. We have also outlined treatment modalities for PIDs, which often entail a multidisciplinary approach involving immunoglobulin replacement, antimicrobial prophylaxis, and, in select cases, hematopoietic stem cell transplantation. Emerging therapies, including gene therapy, hold promise for targeted interventions. In essence, this review encapsulates the complexity of PIDs, emphasizing the critical importance of early diagnosis and tailored therapeutic interventions. As research advances, a clearer understanding of these disorders emerges, fostering optimism for enhanced patient care and management in the future.

COVID-19 in a Patient with X-Linked Agammaglobulinemia: A Case Report

X-linked agammaglobulinemia (XLA), characterized by a profound deficiency of B lymphocytes, is caused by mutations in the gene encoding Bruton tyrosine kinase (Btk).. XLA patients have a susceptibility to viral infections. In this report, we present a 45-year-old man with known XLA, with about a 2-week history of fever, chills, diarrhea and vomiting. He was diagnosed with COVID-19 infection, which was confirmed by a real-time reversetranscriptase- polymerase chain reaction. The antiviral drugs, antibiotics, and interferon-beta were administered to him. Unfortunately, the patient passed away after 5 days. During an epidemic of infectious diseases, the best strategy to overcome the potential challenges of treating XLA may be prevention. Early detection of biomarkers such as D-dimer and IL-6 might be more helpful for initiating more aggressive therapy and decreasing the duration of illness in these patients.