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SHR Neuro Cancer Cardio Lipid Metab Microb
Thalhammer, J; Kindle, G; Nieters, A; Rusch, S; Seppänen, MRJ; Fischer, A; Grimbacher, B; Edgar, D; Buckland, M; Mahlaoui, N; Ehl, S, , European, Society, for, Immunodeficiencies, Registry, Working, Party.
Initial presenting manifestations in 16,486 patients with inborn errors of immunity include infections and noninfectious manifestations.
J Allergy Clin Immunol. 2021; 148(5):1332-1341.e5
Doi: 10.1016/j.jaci.2021.04.015
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- Abstract:
- BACKGROUND: Inborn errors of immunity (IEI) are rare diseases, which makes diagnosis a challenge. A better description of the initial presenting manifestations should improve awareness and avoid diagnostic delay. Although increased infection susceptibility is a well-known initial IEI manifestation, less is known about the frequency of other presenting manifestations. OBJECTIVE: We sought to analyze age-related initial presenting manifestations of IEI including different IEI disease cohorts. METHODS: We analyzed data on 16,486 patients of the European Society for Immunodeficiencies Registry. Patients with autoinflammatory diseases were excluded because of the limited number registered. RESULTS: Overall, 68% of patients initially presented with infections only, 9% with immune dysregulation only, and 9% with a combination of both. Syndromic features were the presenting feature in 12%, 4% had laboratory abnormalities only, 1.5% were diagnosed because of family history only, and 0.8% presented with malignancy. Two-third of patients with IEI presented before the age of 6 years, but a quarter of patients developed initial symptoms only as adults. Immune dysregulation was most frequently recognized as an initial IEI manifestation between age 6 and 25 years, with male predominance until age 10 years, shifting to female predominance after age 40 years. Infections were most prevalent as a first manifestation in patients presenting after age 30 years. CONCLUSIONS: An exclusive focus on infection-centered warning signs would have missed around 25% of patients with IEI who initially present with other manifestations.
- Find related publications in this database (Keywords)
- Primary immunodeficiency
- inborn error of immunity
- presenting symptom
- immune dysregulation
- autoimmune
- inflamma-tory
- syndromic
- warning signs
- registry