2019, Number 4
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Rev Cubana Hematol Inmunol Hemoter 2019; 35 (4)
Primary immunodeficiencies and cytopenias
Casado HI
Language: Spanish
References: 33
Page: 1-17
PDF size: 482.15 Kb.
ABSTRACT
Introduction: The current view of primary immunodeficiency diseases (IDP) includes an increasing number of syndromes that are associated with immune dysregulation and autoimmunity as predominant characteristics. Autoimmune cytopenias may be the first sign of dysregulation that precedes the classic presentation of primary immunodeficiency, with recurrent or opportunistic infections. The knowledge of a spectrum of potentially involved diseases (hematological, rheumatological and immunological) is crucial for the identification of a certain proportion of genotypes and phenotypes of other diagnoses described. It will also allow excluding disorders such as systemic lupus erythematosus, common variable immunodeficiency, autoimmune lymphoproliferative syndrome; as well as making novel differential diagnoses such as GATA2 deficiency, CD27 deficiency, lipopolysaccharide sensitivity deficiency, activated delta phosphoinositol-3-kinase syndrome, X-linked immunodeficiency with magnesium deficiency and others.
Objective: This review provides a conceptual synopsis of the appearance of cytopenias in the IDPs with the purpose of updating current knowledge on this topic and increasing the perception, of both hematologists and immunologists, in relation to the presentation of cytopenias as manifestation of these diseases.
Methods: Original and experimental articles published in the 2009-2019 decade were reviewed in some databases of the Virtual Health Library (VHL) of Cuba.
Conclusions: As the self-limited benign forms of post or parainfectious autoimmune cytopenia, or childhood acquired autoimmune neutropenia, which generally occur independently of a recognized underlying IDP, many of the cytopenias that accompany this disease (but not all) mediated by autoantibodies. It is essential, then, that doctors assess, given the clear evidence of cytopenia, that it may be autoimmune.
REFERENCES
Lehman HK. Autoimmunity and Immune Dysregulation in Primary Immune Deficiency Disorders. Curr Allergy Asthma Rep 2015 Sep;15(9):53. doi 10.1007/s11882-015-0553-x.
Dotta L, Badolato R. Primary immunodeficiencies appearing as combined lymphopenia, neutropenia, and monocytopenia. Immunol Lett. 2014 Oct;161(2):222-5. doi: 10.1016/j.imlet.2013.11.018.
Seidel MG, Kindle G, Gathmann b, Quinti I, Buckland M, van Montfrans J, Scheible R. The European Society for Immunodeficiencies (ESID) Registry Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity. J Allergy Clin Immunol Pract 2019;7:1763- 70.
El-Helou SM, Kerstin Biegner A, Bode S, Ehl SR, Heeg M, Maccari ME, Ritterbusch H et al. The German National Registry of Primary Immunodeficiencies (2012–2017). Front. Immunol. 2019; 10: 1–25. doi 10.3389/fimmu.2019.01272
Chapel H, Prevot J, Gaspar HB, Español T, Bonilla FA, Solis L et al. Primary immune deficiencies – principles of care. Front Immunol. 2014 Dec 15;5:627. doi: 10.3389/fimmu.2014.00627.
Todoric K, Koontz JB, Mattox D, Tarrant TK. Autoimmunity in Immunodeficiency. Curr Allergy Asthma Rep. 2013; 13(4): 361–70. doi 10.1007/s11882-013-0350-3.
Bousfiha AA, Jeddane L, Ailal F, Al Herz W, Conley ME, Cunningham-Rundles CH et al. A Phenotypic Approach for IUIS PID Classification and Diagnosis: Guidelines for Clinicians at the Bedside. J Clin Immunol. 2013; 33(6): 1078–87. doi 10.1007/s10875-013-9901-6.
Fischer A, Provot J, Jais JP, Alcais A. Autoimmune and inflammatory manifestations occur frequently in patients with primary immunodeficiencies. J Allergy Clin Immunol. 2017; 140(5): 1388-93.e8.
Azizi G, Ghanavatinejad A, Abolhassani H, Yazdani R, Rezaei N, Mirshafiey A. Autoimmunity in primary T-cell immunodeficiencies. Expert Rev Clin Immunol. 2016 Sep;12(9):989-1006. doi: 10.1080/1744666X.2016.1177458.
Notarangelo LD. Primary immunodeficiencies (PIDs) presenting with cytopenias. Hematology Am Soc Hematol Educ Program. 2009:139-43. doi: 10.1182/asheducation-2009.1.139.
Castagnoli R, Delmonte OM, Calzoni E, Notarangelo LD. Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives. Front Pediatr. 2019 Aug 8;7:295. doi: 10.3389/fped.2019.00295.
Macías C, Marsán V, Sánchez M, Ustariz C, Alfonso M, Adams Y, de la Guardia O et al. Registro Cubano de Inmunodeficiencias Primarias. Rev Cubana Hematol Inmunol Hemoter 2017; [citado 2019 enero 12];36(S1):[aprox. 0 p.]. Disponible en: http://www.revhematologia.sld.cu/index.php/hih/article/view/791
Sèvea P, Broussollea C, Pavicc M. Déficits immunitaires primitifs et cytopénies autoimmunes de l’adulte. Rev Med Interne 2013; 34: 148–53. doi 10.1016/j.revmed.2012.05.007
Stepensky P, Rensing-Ehl A, Gather R, Revel-Vilk S, Fischer U, Nabhani S et al. Early-onset Evans syndrome, immunodeficiency, and premature immunosenescence associated with tripeptidyl-peptidase II deficiency. Blood. 2015; 125(5):753–61. doi 10.1182/blood-2014-08593202
Seidel MG. Autoimmune and other cytopenias in primary immunodeficiencies: pathomechanisms, novel differential diagnoses, and treatment. Blood. 2014;124(15): 2337-44. doi 10.1182/blood-2014-06-583260.
Puck JM, Rieux-Laucat F, Le Deist F, Straus SE. Autoimmune Lymphoproliferative Syndrome. Primary Immunodeficiency Diseases: A Molecular and Genetic Approach. 2nd Ed. Oxford: Oxford University Press;2007. p. 326-41.
Walter JE, Farmer JR, Foldvari Z, Torgerson TR, Cooper MA. Mechanism-based strategies for the management of autoimmunity and immune dysregulation in primary immunodeficiencies. J Allergy Clin Immunol Pract. 2016;4(6):1089–100. doi 10.1016/j.jaip.2016.08.004.
Feuille EJ, Anooshiravani N, Sullivan KE, Fuleihan RL, Cunningham-Rundles CH. Autoimmune Cytopenias and Associated Conditions in CVID: a Report From the USIDNET Registry. J Clin Immunol. 2018; 38(1): 28–34. doi 10.1007/s10875-017-0456-9.
Mantadakis E, Farmaki E, Taparkou A, Chatzimichael A, Speletas M. Common variable immune deficiency with mutated TNFSRF13B gene presenting with autoimmune hematologic manifestations. Pediatr Hematol Oncol. 2016; 1:83-5.
Ghaithi IA, Wright NAM, Breakey VR, Cox K, Warias A, Wong T et al. Combined Autoimmune Cytopenias Presenting in Childhood. Pediatr Blood Cancer. 2016; 63:292–8.
Rivalta B, Zama D, Pancaldi G, Facchini E, Cantarini ME, Miniaci A, Prete A, Pession A. Evans Syndrome in Childhood: Long Term Follow-Up and the Evolution in Primary Immunodeficiency or Rheumatological Disease. Front Pediatr. 2019;7:304. doi 10.3389/fped.2019.00304
Bonilla FA, Barlan I, Chapel H, Costa-Carvalho BT, Cunningham-Rundles CH, de la Morena MT et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. J Allergy Clin Immunol Pract. 2016; 4(1): 38–59. doi10.1016/j.jaip.2015.07.025.
Llobell A, Español M, Mensa-Vilaro A, Esteve A, Ruiz E, González-Navarro EA et al. From Primary Immunodeficiency to Autoimmunity: How Extreme Situations Highlight the Main Genetic Factors Involved in Autoimmune Disease. MOJ Immunol 2016; 4(1):00113. doi 10.15406/moji.2016.04.00113.
Miano M. How I manage Evans Syndrome and AIHA cases in children. Br J Haematol. 2016; 172: 524–34. doi 10.1111/bjh.13866.
Seif AE, Manno CS, Sheen C, Grupp SA, Teachey DT. Identifying autoimmune lymphoproliferative syndrome in children with Evans syndrome: a multi-institutional study. Blood 2010; 115(11):2142-5. doi 10.1182/blood-2009-08-23952.
Eddou H, Helissey C, Konopacki J, Souleau B, de Revel T, Malfuson JV. Syndrome d’Evans: attention aux diagnostics par excès. Rev. Méd. Interne 2012; 33: 155–8. doi 10.1016/j.revmed.2011.12.006
Schwab CH, Gabrysch A, Olbrich P, Patiño V, Warnatz K, Wolff D, Hoshino A et al. Phenotype, penetrance, and treatment of 133 Cytotoxic T-lymphocyte antigen 4–insufficient subjects. J Allergy Clin Immunol 2018; 142:1932-46.
Santoni de Sio FR, Passerini L, Restelli S, Valente MM, Pramov A, Maccari ME, Sanvito F et al. Role of human forkhead box P3 in early thymic maturation and peripheral T-cell homeostasis. J Allergy Clin Immunol 2018; 142:1909-21.
Fabre A, Marchal S, Barlogis V, Mari B, Barbry P, Rohrlich PS, Forbes LR. et al. Clinical Aspects of STAT3 Gain-of-Function Germline Mutations: A Systematic Review. J Allergy Clin Immunol Pract 2019; 7:1958-69.
Cirillo E, Cancrini C, Azzari CH, Martino S, Martire B, Pession A, Tommasini A. et al. Clinical, Immunological, and Molecular Features of Typical and Atypical Severe Combined Immunodeficiency: Report of the Italian Primary Immunodeficiency Network. Front Immunol. 2019 Aug 13;10:1908. doi: 10.3389/fimmu.2019.01908.
Mojica AM, Elizalde A. GATA2 Deficiency in a Pediatric Patient. J Allergy Clin Immunol Pract. 2019 Jul - Aug;7(6):2021-2022. doi: 10.1016/j.jaip.2019.02.024.
Eren Akarcan S, Edeer Karaca N, Aksu G, Aykut A, Yilmaz Karapinar D, Cetin F, Aydinok Y. Two male siblings with a novel LRBA mutation presenting with different findings of IPEX syndrome. JMM Case Rep. 2018 Oct 15;5(10):e005167. doi: 10.1099/jmmcr.0.005167.
Grimbacher B, Warnatz K, Yong PFK, Korganow AS, Peter HH. The crossroads of autoimmunity and immunodeficiency: Lessons from polygenic traits and monogenic defects. Allergy Clin Immunol 2016; 137: 3-17. doi 10.1016/j.jaci.2015.11.004.