1
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Guerrero-Bermúdez CA, Cardona-Cardona AF, Ariza-Parra EJ, Arostegui JI, Mensa-Vilaro A, Yague J, Vásquez G, Muñoz-Vahos CH. Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome (VEXAS syndrome) with prominent supraglottic larynx involvement: a case-based review. Clin Rheumatol 2022; 41:3565-3572. [DOI: 10.1007/s10067-022-06338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
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2
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Cordero E, Goycochea-Valdivia W, Mendez-Echevarria A, Allende LM, Alsina L, Bravo García-Morato M, Gil-Herrera J, Gudiol C, Len-Abad O, López-Medrano F, Moreno-Pérez D, Muñoz P, Olbrich P, Sánchez-Ramón S, Soler-Palacín P, Aguilera Cros C, Arostegui JI, Badell Serra I, Carbone J, Fortún J, Gonzalez-Granado LI, López-Granados E, Lucena JM, Parody R, Ramakers J, Regueiro JR, Rivière JG, Roca-Oporto C, Rodríguez Pena R, Santos-Pérez JL, Rodríguez-Gallego C, Neth O. Executive Summary of the Consensus Document on the Diagnosis and Management of Patients with Primary Immunodeficiencies. Enferm Infecc Microbiol Clin 2021; 38:438-443. [PMID: 33161954 DOI: 10.1016/j.eimc.2020.07.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/01/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
Primary immunodeficiencies (PIDs) are rare, undiagnosed and potentially fatal diseases. Clinical manifestations of PID can be fatal or leave sequelae that worsen the quality of life of patients. Traditionally, the treatment of PIDs has been largely supportive, with the exception of bone marrow transplantation and, more recently, gene therapy. The discovering of new affected pathways, the development of new molecules and biologics, and the increasing understanding of the molecular basis of these disorders have created opportunities in PIDs therapy. This document aims to review current knowledge and to provide recommendations about the diagnosis and clinical management of adults and children with PIDs based on the available scientific evidence taking in to account current practice and future challenges. A systematic review was conducted, and evidence levels based on the available literature are given for each recommendation where available.
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Affiliation(s)
- Elisa Cordero
- Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, CSIC, University of Seville, Seville, Spain; Department of Medicine, University of Seville, Seville, Spain.
| | - Walter Goycochea-Valdivia
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
| | - Ana Mendez-Echevarria
- Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain
| | - Luis M Allende
- Servicio de Inmunología, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, Spain
| | - Laia Alsina
- Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Institut de Recerca Sant Joan de Déu, Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain
| | - Maria Bravo García-Morato
- Servicio de Inmunología, Hospital Universitario La Paz, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Juana Gil-Herrera
- Department of Immunology, Hospital General Universitario and Health Research Institute Gregorio Marañón, School of Medicine, Univerisdad Complutense, Madrid, Spain
| | - Carlota Gudiol
- Infectious Diseases Department, Hospital Universitari de Bellvitge and Institut Català d'Oncologia (ICO), Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Oscar Len-Abad
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francisco López-Medrano
- Infectious Diseases University Unit, Hospital 12 de Octubre, Instituto de Investigación Biomédica i+12, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - David Moreno-Pérez
- Pediatric Infectology and Immunodeficiencies Unit, Department of Pediatrics, Hospital Regional Universitario de Málaga, IBIMA, RECLIP, University of Malaga, Málaga, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Peter Olbrich
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
| | - Silvia Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Clara Aguilera Cros
- Department of Rheumatology, University Hospital Virgen del Rocío, Sevilla, Spain
| | - Juan Ignacio Arostegui
- Department of Immunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Isabel Badell Serra
- Unidad de Hematología, Oncología y Trasplante Hematopoyético, Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Carbone
- Servicio de Inmunología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jesús Fortún
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis I Gonzalez-Granado
- Primary Immunodeficiencies Unit, Pediatrics, Hospital 12 de Octubre, Research Institute Hospital 12 octubre (i+12), School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Eduardo López-Granados
- Servicio de Inmunología, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Hospital Universitario La Paz, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | | | - Rocío Parody
- Servicio de Hematología Clínica, Institut Català d'Oncologia H. Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jan Ramakers
- Department of Pediatrics, Pediatric Rheumatology and Immunology, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José R Regueiro
- Department of Immunology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Jacques G Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Cristina Roca-Oporto
- Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, CSIC, University of Seville, Seville, Spain
| | - Rebeca Rodríguez Pena
- Servicio de Inmunología, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Hospital Universitario La Paz, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Juan Luis Santos-Pérez
- Infectious Diseases and Immunodeficiencies Unit, Service of Pediatrics, University Hospital Virgen de las Nieves, Granada, Spain
| | - Carlos Rodríguez-Gallego
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain; University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
| | - Olaf Neth
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
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Mozas P, Pineyroa JA, Nadeu F, Magnano L, Rivero A, Rivas-Delgado A, Bataller A, Fabregat A, Gine E, Baumann T, Villamor N, Arostegui JI, Aymerich M, Lopez-Guillermo A, Campo E, Delgado J. Serum monoclonal component in chronic lymphocytic leukemia: baseline correlations and prognostic impact. Haematologica 2021; 106:1754-1757. [PMID: 33147939 PMCID: PMC8168485 DOI: 10.3324/haematol.2020.263228] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Pablo Mozas
- Department of Hematology, Hospital Clínic, Barcelona
| | | | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Laura Magnano
- Department of Hematology, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona
| | - Andrea Rivero
- Department of Hematology, Hospital Clínic, Barcelona
| | | | - Alex Bataller
- Department of Hematology, Hospital Clínic, Barcelona
| | - Aleix Fabregat
- Department of Biochemistry and Molecular Biology, Hospital Clínic, Barcelona
| | - Eva Gine
- Department of Hematology, Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Tycho Baumann
- Department of Hematology, Hospital Clínic, Barcelona
| | - Neus Villamor
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona
| | | | - Marta Aymerich
- Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona
| | - Armando Lopez-Guillermo
- Department of Hematology, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain; Universitat de Barcelona
| | - Julio Delgado
- Department of Hematology, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
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4
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López-Sánchez C, Falla LM, Roé-Crespo E, Arostegui JI, Mozos A, Bernal S, Iznardo H, Baselga-Torres E. Excellent response to secukinumab in an infant with severe generalized pustular psoriasis. J Dermatol 2021; 48:907-910. [PMID: 33543522 DOI: 10.1111/1346-8138.15673] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/02/2020] [Indexed: 02/06/2023]
Abstract
Generalized pustular psoriasis (GPP) represents the rarest form of psoriasis, which may be potentially fatal. In the last decade, (likely) pathogenic variants in the IL36RN, CARD14 and AP1S3 genes have been associated with monogenic GPP forms. Despite these advances, the genetic basis of most patients with GPP remains unidentified. Treatment of GPP patients is often difficult, with no consensus about the best available options to date. We report herein an infant with severe GPP in whom the disease started at the age of 2 months. Genetic investigations identified a heterozygous pathogenic variant in the IL36RN gene associated with a heterozygous variant of uncertain significance in the CARD14 gene. After previous treatment failures with acitretin, cyclosporin and anakinra, treatment with the interleukin-17 antagonist secukinumab resulted in a dramatic and prompt positive response that persisted at 12-month follow up. According to our experience, we believe secukinumab can be an effective and safe treatment for pediatric patients with GPP even before 1 year of age.
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Affiliation(s)
- Cristina López-Sánchez
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lina María Falla
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther Roé-Crespo
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Ana Mozos
- Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sara Bernal
- Genetics Department, Hospital de la Santa Creu i Sant Pau and CIBERER U705, Barcelona, Spain
| | - Helena Iznardo
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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5
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Cordero E, Goycochea-Valdivia W, Mendez-Echevarria A, Allende LM, Alsina L, Bravo García-Morato M, Gil-Herrera J, Gudiol C, Len-Abad O, López-Medrano F, Moreno-Pérez D, Muñoz P, Olbrich P, Sánchez-Ramón S, Soler-Palacín P, Aguilera Cros C, Arostegui JI, Badell Serra I, Carbone J, Fortún J, Gonzalez-Granado LI, López-Granados E, Lucena JM, Parody R, Ramakers J, Regueiro JR, Rivière JG, Roca-Oporto C, Rodríguez Pena R, Santos-Pérez JL, Rodríguez-Gallego C, Neth O. Executive Summary of the Consensus Document on the Diagnosis and Management of Patients with Primary Immunodeficiencies. J Allergy Clin Immunol Pract 2020; 8:3342-3347. [PMID: 33161963 DOI: 10.1016/j.jaip.2020.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 10/23/2022]
Abstract
Primary immunodeficiencies (PIDs) are rare, undiagnosed and potentially fatal diseases. Clinical manifestations of PID can be fatal or leave sequelae that worsen the quality of life of patients. Traditionally, the treatment of PIDs has been largely supportive, with the exception of bone marrow transplantation and, more recently, gene therapy. The discovering of new affected pathways, the development of new molecules and biologics, and the increasing understanding of the molecular basis of these disorders have created opportunities in PIDs therapy. This document aims to review current knowledge and to provide recommendations about the diagnosis and clinical management of adults and children with PIDs based on the available scientific evidence taking in to account current practice and future challenges. A systematic review was conducted, and evidence levels based on the available literature are given for each recommendation where available.
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Affiliation(s)
- Elisa Cordero
- Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, CSIC, University of Seville, Seville, Spain; Department of Medicine, University of Seville, Seville, Spain.
| | - Walter Goycochea-Valdivia
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
| | - Ana Mendez-Echevarria
- Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario La Paz, Madrid, Spain
| | - Luis M Allende
- Servicio de Inmunología, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, Spain
| | - Laia Alsina
- Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Institut de Recerca Sant Joan de Déu, Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain
| | - Maria Bravo García-Morato
- Servicio de Inmunología, Hospital Universitario La Paz, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Juana Gil-Herrera
- Department of Immunology, Hospital General Universitario and Health Research Institute Gregorio Marañón, School of Medicine, Univerisdad Complutense, Madrid, Spain
| | - Carlota Gudiol
- Infectious Diseases Department, Hospital Universitari de Bellvitge and Institut Català d'Oncologia (ICO), Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Oscar Len-Abad
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francisco López-Medrano
- Infectious Diseases University Unit, Hospital 12 de Octubre, Instituto de Investigación Biomédica i+12, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - David Moreno-Pérez
- Pediatric Infectology and Immunodeficiencies Unit, Department of Pediatrics, Hospital Regional Universitario de Málaga, IBIMA, RECLIP, University of Malaga, Málaga, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Peter Olbrich
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
| | - Silvia Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Clara Aguilera Cros
- Department of Rheumatology, University Hospital Virgen del Rocío, Sevilla, Spain
| | - Juan Ignacio Arostegui
- Department of Immunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Isabel Badell Serra
- Unidad de Hematología, Oncología y Trasplante Hematopoyético, Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Carbone
- Servicio de Inmunología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jesús Fortún
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis I Gonzalez-Granado
- Primary Immunodeficiencies Unit, Pediatrics, Hospital 12 de Octubre, Research Institute Hospital 12 octubre (i+12), School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Eduardo López-Granados
- Servicio de Inmunología, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Hospital Universitario La Paz, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | | | - Rocío Parody
- Servicio de Hematología Clínica, Institut Català d'Oncologia H. Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jan Ramakers
- Department of Pediatrics, Pediatric Rheumatology and Immunology, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José R Regueiro
- Department of Immunology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Jacques G Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Cristina Roca-Oporto
- Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, CSIC, University of Seville, Seville, Spain
| | - Rebeca Rodríguez Pena
- Servicio de Inmunología, Instituto de Investigación Biomédica del Hospital La Paz (IdiPAZ), Hospital Universitario La Paz, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Juan Luis Santos-Pérez
- Infectious Diseases and Immunodeficiencies Unit, Service of Pediatrics, University Hospital Virgen de las Nieves, Granada, Spain
| | - Carlos Rodríguez-Gallego
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain; University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
| | - Olaf Neth
- Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain
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Morán-Villaseñor E, Saez-de-Ocariz M, Torrelo A, Arostegui JI, Yamazaki-Nakashimada MA, Alcántara-Ortigoza MA, González-Del-Angel A, Velázquez-Aragón JA, López-Herrera G, Berrón-Ruiz L, García-Romero MT. Expanding the clinical features of autoinflammation and phospholipase Cγ2-associated antibody deficiency and immune dysregulation by description of a novel patient. J Eur Acad Dermatol Venereol 2019; 33:2334-2339. [PMID: 31465591 DOI: 10.1111/jdv.15918] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Autoinflammation and phospholipase Cγ2-associated antibody deficiency and immune dysregulation (APLAID) is an exceedingly rare monogenic autoinflammatory disease. To date, only five cases have been reported with four distinct pathogenic mutations. OBJECTIVES We present a novel case of APLAID, corroborated by molecular analysis, with newly described clinical findings including central nervous system vasculitis (CNSV); and distinctive histopathological characteristics that may expand our knowledge of this rare disease's phenotype. METHODS This is a case report presentation of a 3-year-old boy, seen at a reference paediatric hospital in Mexico. His parents authorized the use of his clinical information and photographs. RESULTS A 3-day-old boy presented to the emergency department with a vesiculo-pustular rash that resolved within 1 week. Two months later, he developed widespread papules and pseudovesicles that evolved into infiltrated plaques. He also had periodical flares of conjunctivitis, diarrhoea and erythematous blistering acral plaques triggered by upper respiratory infections. By the age of 10 months, he experienced seizures and CNSV. Laboratory work-up showed mild neutropenia, decreased serum levels of immunoglobulins and B-cell lymphopenia. A skin biopsy revealed a dense, perivascular and interstitial histiocytic and granulomatous infiltrate, with palisading granulomas, and leucocytoclastic vasculitis with karyorrhexis. APLAID syndrome was confirmed by Sanger sequencing of PLCG2 gene [heterozygous genotype LRG_376t1:c.2543T>C or p.(Leu848Pro)]. CONCLUSIONS Presence of CNSV has not been previously described in APLAID, however as the number of reported patients with APLAID is very small, it is possible that the overall spectrum of clinical manifestations has not been completely elucidated. The herein identified p.(Leu848Pro) variant was also documented in a Portuguese patient, suggesting that it could be a PLCG2 gene 'hot-spot'.
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Affiliation(s)
- E Morán-Villaseñor
- Department of Dermatology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - M Saez-de-Ocariz
- Department of Dermatology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - J I Arostegui
- Department of Immunology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | | | - A González-Del-Angel
- Laboratory of Molecular Biology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - J A Velázquez-Aragón
- Laboratory of Molecular Biology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - G López-Herrera
- Immunodeficiencies Research Unit, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - L Berrón-Ruiz
- Immunodeficiencies Research Unit, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - M T García-Romero
- Department of Dermatology, Instituto Nacional de Pediatría, Mexico City, Mexico
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7
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Gattorno M, Hofer M, Federici S, Vanoni F, Bovis F, Aksentijevich I, Anton J, Arostegui JI, Barron K, Ben-Cherit E, Brogan PA, Cantarini L, Ceccherini I, De Benedetti F, Dedeoglu F, Demirkaya E, Frenkel J, Goldbach-Mansky R, Gul A, Hentgen V, Hoffman H, Kallinich T, Kone-Paut I, Kuemmerle-Deschner J, Lachmann HJ, Laxer RM, Livneh A, Obici L, Ozen S, Rowczenio D, Russo R, Shinar Y, Simon A, Toplak N, Touitou I, Uziel Y, van Gijn M, Foell D, Garassino C, Kastner D, Martini A, Sormani MP, Ruperto N. Classification criteria for autoinflammatory recurrent fevers. Ann Rheum Dis 2019; 78:1025-1032. [DOI: 10.1136/annrheumdis-2019-215048] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 01/13/2023]
Abstract
BackgroundDifferent diagnostic and classification criteria are available for hereditary recurrent fevers (HRF)—familial Mediterranean fever (FMF), tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS), mevalonate kinase deficiency (MKD) and cryopyrin-associated periodic syndromes (CAPS)—and for the non-hereditary, periodic fever, aphthosis, pharyngitis and adenitis (PFAPA). We aimed to develop and validate new evidence-based classification criteria for HRF/PFAPA.MethodsStep 1: selection of clinical, laboratory and genetic candidate variables; step 2: classification of 360 random patients from the Eurofever Registry by a panel of 25 clinicians and 8 geneticists blinded to patients’ diagnosis (consensus ≥80%); step 3: statistical analysis for the selection of the best candidate classification criteria; step 4: nominal group technique consensus conference with 33 panellists for the discussion and selection of the final classification criteria; step 5: cross-sectional validation of the novel criteria.ResultsThe panellists achieved consensus to classify 281 of 360 (78%) patients (32 CAPS, 36 FMF, 56 MKD, 37 PFAPA, 39 TRAPS, 81 undefined recurrent fever). Consensus was reached for two sets of criteria for each HRF, one including genetic and clinical variables, the other with clinical variables only, plus new criteria for PFAPA. The four HRF criteria demonstrated sensitivity of 0.94–1 and specificity of 0.95–1; for PFAPA, criteria sensitivity and specificity were 0.97 and 0.93, respectively. Validation of these criteria in an independent data set of 1018 patients shows a high accuracy (from 0.81 to 0.98).ConclusionEurofever proposes a novel set of validated classification criteria for HRF and PFAPA with high sensitivity and specificity.
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Palmou-Fontana N, Armesto S, Martin-Penagos L, Arostegui JI, Portilla-Gonzalez V, Varillas JLM, Vian CD, Gonzalez-Gay MA. E039 Late onset cryopyrin-associated periodic syndrome due to myeloid-restricted somatic NLRP3 mosaicism and ankylosing spondylitis. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez110.038] [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: 11/15/2022] Open
Affiliation(s)
| | - Susana Armesto
- Dermatology, University Hospital Marques de Valdecilla, Satander, SPAIN
| | | | | | | | | | - Carlos Duran Vian
- Dermatology, University Hospital Marques de Valdecilla, Satander, SPAIN
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9
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Podlipnik S, Castellanos-Moreira R, Florez-Enrich H, Arostegui JI, Mascaró JM. Acute generalized exanthematous pustulosis and polyarthritis associated with a novel CARD14 mutation. Australas J Dermatol 2017; 59:e70-e73. [PMID: 28776328 DOI: 10.1111/ajd.12669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/01/2017] [Indexed: 11/29/2022]
Abstract
Acute generalised exanthematous pustulosis (AGEP) is a rare toxicoderma characterised by an acute onset rash, with many sterile pustules on the surface, high fever and increased acute phase reactants. We report the case of a patient who presented to the dermatology department with an AGEP and polyarthritis, in which a novel CARD14 mutation was identified. The pathophysiological mechanism of AGEP remains unclear, although mutations in the IL36RN gene have been identified in a small subset of AGEP patients. Similarly, mutations in the CARD14 gene have been linked to pustular types of psoriasis and familiar cases of pityriasis rubra pilaris; however, there are no reports associating mutations in the CARD14 gene with AGEP.
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Affiliation(s)
- Sebastian Podlipnik
- Department of Dermatology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Raul Castellanos-Moreira
- Department of Rheumatology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Helena Florez-Enrich
- Department of Rheumatology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Ignacio Arostegui
- Department of Immunology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Manuel Mascaró
- Department of Dermatology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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10
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Gonzalez-Roca E, Ruiz-Ortiz E, Anton MC, Plaza S, Mensa-Vilaro A, Yagüe J, Arostegui JI. Development of a workflow to analyze autoinflammatory-associated genes using AccessArray™ system and next generation sequencing. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597322 DOI: 10.1186/1546-0096-13-s1-o81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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11
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Mensa-Vilaro A, De Inocencio J, Cham WT, Gonzalez-Roca E, Tejada-Palacios P, Tang SP, Ruiz-Ortiz E, Enriquez-Merayo E, Lim SC, Magri G, Plaza S, Anton MC, Cerutti A, Ariffin R, Yagüe J, Arostegui JI. NOD2 mosaicism in Blau syndrome. Pediatr Rheumatol Online J 2015. [PMCID: PMC4598915 DOI: 10.1186/1546-0096-13-s1-p59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Gonzalez-Roca E, Mensa-Vilaro A, Plaza S, Anton MC, Rius J, Ruiz-Ortiz E, Campistol JM, Souto A, Cañellas J, Nakagawa K, Nishikomori R, Yagüe J, Arostegui JI. Somatic NLRP3 mosaicism in Muckle-Wells syndrome. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599376 DOI: 10.1186/1546-0096-13-s1-p61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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13
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Mensa-Vilaro A, Bosque-Peralta MT, Gonzalez-Roca E, Casorran-Berges M, Delgado-Beltran C, Plaza S, Anton MC, Ruiz-Ortiz E, Yagüe J, Arostegui JI. Description of a case of late-onset cryopyrin-associated periodic syndrome due to low-level somatic NLRP3 mosaicism. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599881 DOI: 10.1186/1546-0096-13-s1-p60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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14
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Ruiz-Ortiz E, Gonzalez-Roca E, Mensa-Vilaro A, Rius J, Plaza S, Anton C, Calvo I, Modesto C, Anton J, Arnal C, Alvarez C, Alvarez-Coca J, Becerra E, Bilbao N, Camacho M, Crespo J, de Diego C, Diez-Garcia LF, Espinosa L, Garcia-Escriva D, de Gracia F, Gonzalez MI, Iglesias E, Izquierdo S, Lastra B, Llobet P, Lopez B, Lopez-Gonzalez V, Martinez R, Martin-Mateos MA, Merino R, Ortega L, Peiro ME, de Soto IP, Perez-Mendez C, Rodriguez-Valverde V, Ribes A, Ruiz A, Sanchez B, Santos JL, Sevilla B, Sotoca J, Vilas J, Villoria A, Yagüe J, Arostegui JI. Clinical and genetic features of Spanish patients with Mevalonate kinase deficiency. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597073 DOI: 10.1186/1546-0096-13-s1-p36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Murias S, Alcobendas R, Remesal A, Peralta J, Noval S, Arostegui JI, Rodriguez-Pena R, Mendez A, Merino R. Clinical manifestations of four patients diagnosed with early-onset sarcoidosis or sarcoid-like syndrome. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191573 DOI: 10.1186/1546-0096-12-s1-p293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Federici S, Frenkel J, Ozen S, Antòn J, Arostegui JI, De Benedetti F, Dolezalova P, Girschick H, Hentgen V, Hofer M, Lachmann H, Koné-Paut I, Kuemmerle-Deschner J, Neven B, Ozdogan H, Rose C, Simon A, Stojanov S, Toplak N, Touitou I, Vesely R, Woo P, Wouters C, Ruperto N, Martini A, Gattorno M. PReS-FINAL-2337: The eurofever registry: 3 years of enrollment. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044970 DOI: 10.1186/1546-0096-11-s2-p327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Gonzalez-Roca E, Espinosa G, Bartra J, Ruiz-Ortiz E, Rius J, Plaza S, Yague J, Arostegui JI. P02-021 - Atypical CAPS consequence of novel NLPR3 mutations. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953046 DOI: 10.1186/1546-0096-11-s1-a128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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18
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Milá M, Rufach A, Dapena JL, Arostegui JI, Elorza I, Llort A, Sánchez de Toledo J, Díaz de Heredia C. [Severe congenital neutropenia: analysis of clinical features, diagnostic methods, treatment and long-term outcome]. An Pediatr (Barc) 2011; 75:396-400. [PMID: 21757412 DOI: 10.1016/j.anpedi.2011.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 05/29/2011] [Accepted: 05/30/2011] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Severe congenital neutropenia (SCN), a heterogeneous condition with onset at early ages, is characterised by primary myelopoiesis failure with an absolute neutrophil count (ANC) < 0.5 x10(9)/L, severe infections and risk of leukaemic transformation. OBJECTIVE The aim of the study was to ascertain the long term outcome of patients with SCN. MATERIAL AND METHODS The clinical features, diagnostic methods, treatment and outcome of 11 patients with SCN were analysed. RESULTS The median age at diagnosis was 4 months (range: 3 days-12 years). The primary clinical manifestation was severe infection. Median ANC at diagnosis: 0.2 x 10(9)/L (range: 0-0.37). Bone marrow aspirate showed maturation arrest at promyelocyte stage in all cases. Genetic studies revealed 3 mutations, two in ELA-2 gene and 1 in G6PC3 gene, showing a correlation between genotype and phenotype. Granulocyte Colony Stimulating Factor (G-CSF) was the first-line treatment in 9 patients; six of whom showed a good response at doses between 5 and 15 μg/kg/day for 3-7 days/week. The remaining 3 patients failed to respond to G-CSF and allogeneic stem cell transplantation (SCT) was indicated. Furthermore, SCT was the treatment of choice in two cases. Median follow-up of the cohort was 5 years (range: 1-10 years) with 100% survival and no cases of leukaemic transformation. CONCLUSIONS We conclude that genetic study is useful for establishing a correlation between genotype and phenotype. The treatment of choice for SCN is G-CSF to which 2/3 of patients should respond; while SCT is reserved for cases of poor response or those evolving to myelodysplastic syndrome (MDS) or leukaemia; thus close follow-up of this condition is essential.
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Affiliation(s)
- M Milá
- Servicio de Oncología y Hematología Pediátricas, Hospital Materno-Infantil Vall d'Hebron, Barcelona, España.
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19
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Graell E, Arostegui JI, Sanmartí R, Blanco FJ, Yagüe J, Pinto JA, Plaza S, Fernández-Sueiro JL, González A, Cañete JD. Possible association between NOD2 variants and joint surgery in psoriatic arthritis. Clin Exp Rheumatol 2010; 28:30-34. [PMID: 20346235] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Psoriatic arthritis (PsA) has been inconsistently associated with common NOD2 gene variants, although some of these studies did not include patient stratification by clinical phenotype. OBJECTIVES To analyse the association between the three common NOD2 variants (R702W, G908R and L1007fs) and clinical phenotypes of PsA, particularly with surrogate markers of severe joint destruction. PATIENTS AND METHODS A total of 183 unrelated PsA patients and 187 controls were included. Demographic, clinical, biological and immunological characteristics were collected. Genotypes for the three common NOD2 gene variants were obtained by PCR and direct sequencing. RESULTS NOD2 variants in PsA patients (7.6%) are just as prevalent as in healthy controls (7.5%). 18.5% of PsA patients carrying at least one NOD2 variant underwent joint surgery compared with 4.5% of those without these variants (p=0.019). Multivariate analysis confirmed this finding (OR 8.82, CI 1.7-46.3). There was no requirement for early surgery in patients carrying the NOD2 variants but there was an increased possibility of requiring surgery at similar times of disease duration. No other association with clinical features and NOD2 status carrier was found. CONCLUSIONS Common NOD2 gene variants are not associated with PsA, but might increase the risk of undergoing joint replacement surgery, suggesting that this autoinflammatory-associated gene could act as a phenotypic modifier gene in PsA patients by increasing the risk of joint destruction. Given the small number of PsA patients with joint surgery included, we consider our findings a new hypothesis that will need further testing.
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Affiliation(s)
- E Graell
- Arthritis Unit, Rheumatology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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20
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Colobran R, Casamitjana N, Roman A, Faner R, Pedrosa E, Arostegui JI, Pujol-Borrell R, Juan M, Palou E. Copy number variation in the CCL4L gene is associated with susceptibility to acute rejection in lung transplantation. Genes Immun 2009; 10:254-9. [PMID: 19148142 DOI: 10.1038/gene.2008.96] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Lung transplantation (LT) has become an accepted therapy for selected patients with advanced lung disease. One of the main limitations to successful LT is rejection of the transplanted organ where chemokines are pivotal mediators. Here, we test the relationship between copy number variation (CNV) in the CCL4L chemokine gene and rejection risk in LT patients (n=161). Patients with no acute rejection showed a significantly lower mean number of CCL4L copies than patients that showed acute rejection (1.66 vs 1.96, P=0.014), with an even greater number of gene copies seen in patients with more than one episode of acute rejection (1.66 vs 2.30, P=0.001). Additionally, patients with > or =2 CCL4L copies had a significantly higher risk of acute rejection compared with patients that had 0-1 CCL4L copies (odds ratio 2.65; 95% confidence interval, 1.33-5.28; P=0.0046). A combined analysis of CCL4L CNV and the rs4796195 CCL4L single nucleotide polymorphism demonstrated that the effect of CCL4L copy number in acute rejection is mainly because of the number of copies of the CCL4L1 allelic variant. This finding constitutes the first report of CNV as a correlate factor in allograft rejection.
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Affiliation(s)
- R Colobran
- Laboratori d'Immunobiologia per a la Recerca i Aplicacions Diagnòstiques, Banc de Sang i Teixits, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
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21
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Marco A, Calvo I, Lopez B, Arostegui JI, Yagüe J. Hiper IgD syndrome (HIDS): clinical and genetic features in five patients. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334002 DOI: 10.1186/1546-0096-6-s1-p199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Alvarez-Lobos M, Arostegui JI, Sans M, Tassies D, Piu J, Reverter JC, Pique JM, Yagüe J, Panés J. Combined type-1 plasminogen activator inhibitor and NOD2/CARD15 genotyping predicts complicated Crohn's disease behaviour. Aliment Pharmacol Ther 2007; 25:429-40. [PMID: 17269998 DOI: 10.1111/j.1365-2036.2006.03208.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND NOD2/CARD15 gene variants have not been universally associated with stricturing behaviour in Crohn's disease. Other behaviour modifying genes could explain these results. AIM To study the combined influence of NOD2/CARD15 variants and 4G/4G genotype of type-1 plasminogen activator inhibitor (PAI-1) gene on Crohn's disease behaviour. METHODS One hundred and seventy Crohn's disease patients were studied prospectively, with a mean follow-up of 7+/- 6 years. Disease behaviour was registered by using two criteria: the Vienna classification and a non-hierarchical classification based on the behavioural Vienna categories. RESULTS In the multivariate analysis for stricturing behaviour according to the Vienna categories, only absence of colonic disease (OR, 4.0; 95% CI: 1.49-11.1; P = 0.006) was an independent predictive factor. However, in the multivariate analysis for stricturing disease applying a non-hierarchical criteria, ileal disease (OR, 4.19; 95% CI: 1.30-13.5; P = 0.01), and carrying both NOD2/CARD15 variants and the 4G/4G PAI-1 genotype (OR, 5.02; 95% CI: 1.44-17.48; P = 0.01) were independent predictive factors. In the multivariate analysis for penetrating behaviour, the 4G/4G PAI-1 (OR, 3.10; 95% CI: 1.54-6.23; P = 0.001) and male sex (OR, 2.44; 95% CI: 1.30-4.60; P = 0.005) were independent predictive factors irrespective of criteria applied. CONCLUSIONS Combined PAI-1 and NOD2/CARD15 genotyping predict complicated Crohn's disease. Patients with these variants could benefit from early interventions.
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Affiliation(s)
- M Alvarez-Lobos
- Department of Gastroenterology, Hospital Clinic, CIBER-HEPAD, Barcelona, Spain
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23
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Espinosa G, Arostegui JI, Plaza S, Rius J, Cervera R, Yagüe J, Font J. Behçet's disease and hereditary periodic fever syndromes: casual association or causal relationship? Clin Exp Rheumatol 2005; 23:S64-6. [PMID: 16273767] [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] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Mutations in the MEFV and the type 1 TNF receptor (TNFRSF 1A) genes have recently been linked to familial Mediterranean fever (FMF) and TNF receptor-associated periodic syndrome (TRAPS), respectively. A higher prevalence of Behçet's disease (BD) among FMF patients has been described compared to the general population. The aim of this study was to evaluate whether FMF TRAPS and BD could be genetically related. METHODS We screened a cohort of 50 BD patients and 100 healthy subjects for the common MEFV and TNFRSF 1A mutations. An initial screening of exons 10 and 2 of the MEFV gene and exon 4 of the TNFRSF 1A was performed in all chromosomes. RESULTS The heterozygous MEFV mutation (K695R) was found in one (2%) BD patient. Analysis for FMF mutations in the control group revealed that 5 (5%) individuals bore MEFV gene mutations (3 were heterozygous for the E148Q and 2 were heterozygous for the A744S). At codon 202, there were no differences in allele frequencies between BD and control population: 73%R 27%Q in the BD patients vs 75%R 25%Q in controls. Concerning mutations in the TNFRSF 1A gene, the R92Q mutation was present in heterozygous state in one (2%) BD patient and in 4 (4%) controls without differences between allele frequencies: 99%R 1%Q in BD patients vs 98%R 2%Q in controls, respectively. There was no association between the clinical manifestations of BD patients and the presence of a particular polymorphism or a mutation. CONCLUSIONS Neither FMF nor TRAPS are genetically associated with BD in our cohort of Spanish patients.
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Affiliation(s)
- G Espinosa
- Systemic Autoimmune Diseases Unit, Institut d 'Inves- tigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, Barcelona, Catalonia, Spain.
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de la Calle-Martin O, Hernandez M, Ordi J, Casamitjana N, Arostegui JI, Caragol I, Ferrando M, Labrador M, Rodriguez-Sanchez JL, Espanol T. Familial CD8 deficiency due to a mutation in the CD8 alpha gene. J Clin Invest 2001; 108:117-23. [PMID: 11435463 PMCID: PMC209336 DOI: 10.1172/jci10993] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CD8 glycoproteins play an important role in both the maturation and function of MHC class I-restricted T lymphocytes. A 25-year-old man, from a consanguineous family, with recurrent bacterial infections and total absence of CD8(+) cells, was studied. Ab deficiencies and ZAP-70 and TAP defects were ruled out. A missense mutation (gly90-->ser) in both alleles of the immunoglobulin domain of the CD8 alpha gene was shown to correlate with the absence of CD8 expression found in the patient and two sisters. Conversely, high percentages of CD4(-)CD8(-)TCR alpha beta(+) T cells were found in the three siblings. A novel autosomal recessive immunologic defect characterized by absence of CD8(+) cells is described. These findings may help to further understanding of the role of CD8 molecules in human immune response.
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Affiliation(s)
- O de la Calle-Martin
- Department of Immunology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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