Sogkas Georgios, Atschekzei Faranaz, Schacht Vivien, von Falck Christian, Jablonka Alexandra, Jacobs Roland, Stoll Matthias, Witte Torsten, Schmidt Reinhold E
Division of Immunology and Rheumatology, Hannover Medical University, Hanover, Germany.
Division of Dermatology, Hannover Medical University, Hanover, Germany.
Front Immunol. 2017 Jul 28;8:885. doi: 10.3389/fimmu.2017.00885. eCollection 2017.
Interleukin 12 receptor beta 1 (IL12Rβ1) deficiency is a primary immunodeficiency resulting mainly in susceptibility to opportunistic infection by non-tuberculous, environmental mycobacteria and severe infection caused by spp. Till now, less than 300 patients with IL12Rβ1 deficiency have been reported. Among them, only three have been described to develop autoimmunity.
We present the case of a 50-year-old male with IL12Rβ1 deficiency due to compound + > , who-18 months after diagnosis of disseminated BCGitis-presented with recurrent fever and sicca syndrome. No indication of an infectious origin of these symptoms could be found at that point. The diagnosis of a Sjögren's syndrome (SS) was made on the basis of fulfilled American-European consensus classification criteria, including a positive minor salivary gland biopsy.
Apart from persistent antigenic stimulation, which may drive autoimmune inflammation in primary immunodeficiency, evidence on the involvement of interleukin 12 in pathogenesis of SS suggests that the same immunological mechanism may underlie both defense against infection and the maintenance of tolerance. To our knowledge, this is the first report of a case of autoimmunity in the form of SS in a patient with a primary immunodeficiency and one of the rare cases of IL12Rβ1 deficiency with manifested autoimmunity.
白细胞介素12受体β1(IL12Rβ1)缺陷是一种原发性免疫缺陷病,主要导致对非结核性环境分枝杆菌的机会性感染以及由[具体菌种]引起的严重感染易感性增加。截至目前,报道的IL12Rβ1缺陷患者不足300例。其中,仅有3例被描述发生了自身免疫。
我们报告一例50岁男性,因复合[具体基因组合]导致IL12Rβ1缺陷,在诊断播散性卡介苗病18个月后出现反复发热和干燥综合征。当时未发现这些症状有感染性病因。根据美国-欧洲共识分类标准(包括小唾液腺活检阳性)确诊为干燥综合征(SS)。
除了可能在原发性免疫缺陷中驱动自身免疫炎症的持续抗原刺激外,白细胞介素12参与SS发病机制的证据表明,抗感染防御和维持免疫耐受可能具有相同的免疫机制。据我们所知,这是首例原发性免疫缺陷患者以SS形式出现自身免疫的病例报告,也是罕见的表现为自身免疫的IL12Rβ1缺陷病例之一。