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Boz V, Tesser A, Girardelli M, Burlo F, Pin A, Severini GM, De Marchi G, Verzegnassi F, Naviglio S, Tommasini A, Valencic E. Inborn Errors of Immunity in Children with Autoimmune and Allergic Complaints: A Single Center Experience from Diagnosis to Treatment. Biomedicines 2023; 11:biomedicines11051299. [PMID: 37238969 DOI: 10.3390/biomedicines11051299] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Inborn errors of immunity (IEI) associated with immune dysregulation are not sufficiently addressed in shared recommendation, resulting in delayed diagnosis and high morbidity. The availability of precision medicine for some of these immune defects makes it urgent to evaluate effective strategies to diagnose and treat such defects before the occurrence of severe complications. A diagnosis of an IEI in these patients enabled the use of a more specific treatment in most cases, and these have the potential to prevent further disease progression. We studied immune dysregulation diseases in 30 patients with autoimmune or allergic phenotypes, exploiting data from clinics and immunophenotype, genetic and transcriptome investigations, and 6 of them were diagnosed with a monogenic disorder. Our results confirm that a non-negligible number of children with IEIs may present with signs and symptoms of immune dysregulation and share many features with common multifactorial immune conditions. Reaching a genetic diagnosis becomes more likely in the presence of multiple clinical manifestations, especially when in association with abnormalities of lymphocytes subsets and/or immunoglobulins levels. Moreover, 5 of 6 patients that obtained a diagnosis of monogenic disorder received precision therapy, in four cases with a good or moderate response.
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Affiliation(s)
- Valentina Boz
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Alessandra Tesser
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Martina Girardelli
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Francesca Burlo
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Alessia Pin
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Giovanni Maria Severini
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Ginevra De Marchi
- Rheumatology Clinic, Department of Medical and Biological Sciences, Azienda Sanitaria Universitaria Friuli Centrale c/o, University of Udine, 33100 Udine, Italy
| | - Federico Verzegnassi
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Samuele Naviglio
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
| | - Alberto Tommasini
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Erica Valencic
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65, 34137 Trieste, Italy
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