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普通变异型免疫缺陷:自身免疫性血细胞减少症与分子诊断进展

Common variable immunodeficiency: autoimmune cytopenias and advances in molecular diagnosis.

作者信息

Cunningham-Rundles Charlotte, Casanova Jean-Laurent, Boisson Bertrand

机构信息

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.

出版信息

Hematology Am Soc Hematol Educ Program. 2024 Dec 6;2024(1):137-142. doi: 10.1182/hematology.2024000538.

Abstract

Common variable immunodeficiency (CVID) is one of the most common groups of human inborn errors of immunity. In addition to infections resulting from insufficient levels of immunoglobulins and antibodies, a significant proportion of patients develop autoimmune cytopenias, especially immune thrombocytopenia, hemolytic anemia, or neutropenia. They may be the initial manifestation of CVID in a patient who has not had significant infections, and similar episodes may recur at intervals over time. Treatment of these hematologic complications includes the use of corticosteroids or other medications, often including rituximab; splenectomy is discouraged. Here we outline the overall occurrence of these blood cytopenias in a cohort of 408 patients, as well as the clinical and genetic associations noted in these individuals.

摘要

常见变异型免疫缺陷(CVID)是人类最常见的先天性免疫缺陷群体之一。除了因免疫球蛋白和抗体水平不足导致的感染外,相当一部分患者会出现自身免疫性血细胞减少症,尤其是免疫性血小板减少症、溶血性贫血或中性粒细胞减少症。它们可能是未发生严重感染的患者CVID的初始表现,类似发作可能会随时间间隔复发。这些血液学并发症的治疗包括使用皮质类固醇或其他药物,通常包括利妥昔单抗;不建议进行脾切除术。在此,我们概述了408例患者队列中这些血细胞减少症的总体发生率,以及这些个体中观察到的临床和遗传关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/903b/11665743/ffd821ab1b11/hem.2024000538_s1.jpg

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