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摩洛哥先天性免疫缺陷患儿的自身免疫表现:一项来自国家登记处的研究。

Autoimmune manifestations in children with inborn errors of immunity in Morocco: A study from the national registry.

作者信息

Elamine Ahamada, Benhsaien Ibtihal, Ailal Fatima, Errami Abderrahmane, Kasmi Zakaria, Aadam Zahra, Bourhanbour Asmaa Drissi, Bousfiha Ahmed Aziz, El Bakkouri Jalila

机构信息

Laboratory of Clinical Immunology, Infection and Autoimmunity (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Department of Pediatric Infectious Diseases and Clinical Immunology, Mother and Child Hospital, Abderrahim HAROUCHI of Casablanca, Morocco.

出版信息

J Transl Autoimmun. 2025 Jun 26;11:100299. doi: 10.1016/j.jtauto.2025.100299. eCollection 2025 Dec.


DOI:10.1016/j.jtauto.2025.100299
PMID:40678816
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12268102/
Abstract

Inborn Errors of Immunity (IEI) are a heterogeneous group of genetic disorders characterized by increased susceptibility to infections and immune dysregulation, including autoimmunity and autoinflammation. Despite their clinical significance, data on autoimmune manifestations in Moroccan pediatric patients with IEI remain limited. This study aims to investigate the prevalence, spectrum, and clinical patterns of autoimmune manifestations in pediatric patients with IEI in Morocco. We conducted a retrospective analysis of pediatric patients registered in the Moroccan IEI registry from January 2007 to December 2023. Demographic, clinical, and laboratory data were extracted, with a particular focus on autoimmune manifestations. Among 769 patients registered in the Moroccan IEI registry, 108 (14 %) exhibited at least one autoimmune manifestation. Consanguinity was observed in 59 (55 %) of cases, and the male-to-female ratio was 1.14. The median age at the onset of clinical symptoms was 10 months (2-33 months), and the median age at IEI diagnosis was 30 months (10.5-84 months). A total of 191 autoimmune manifestations were recorded among these patients, with a notable predominance of autoimmune cytopenia (72 %), followed by cutaneous (10 %) and gastrointestinal (9 %) manifestations. Poly-autoimmunity was present in 47.3 % of affected patients. The most frequently associated IEI subtype with these autoimmune manifestations was common variable immunodeficiency (16,7 %). Autoimmune manifestations are a frequent complication in Moroccan children with IEI, with autoimmune cytopenias predominating. A high index of suspicion for IEI should be maintained in patients initially presenting with autoimmunity, particularly autoimmune cytopenia. These patients require personalized management due to their higher risk of mortality.

摘要

遗传性免疫缺陷病(IEI)是一组异质性的遗传疾病,其特征为易患感染性疾病以及免疫失调,包括自身免疫和自身炎症。尽管其具有临床重要性,但摩洛哥儿科IEI患者自身免疫表现的数据仍然有限。本研究旨在调查摩洛哥儿科IEI患者自身免疫表现的患病率、范围及临床模式。我们对2007年1月至2023年12月在摩洛哥IEI登记处登记的儿科患者进行了回顾性分析。提取了人口统计学、临床和实验室数据,特别关注自身免疫表现。在摩洛哥IEI登记处登记的769例患者中,108例(14%)表现出至少一种自身免疫表现。59例(55%)病例存在近亲结婚,男女比例为1.14。临床症状出现的中位年龄为10个月(2 - 33个月),IEI诊断的中位年龄为30个月(10.5 - 84个月)。这些患者共记录到191种自身免疫表现,其中自身免疫性血细胞减少症显著占优势(72%),其次是皮肤表现(10%)和胃肠道表现(9%)。47.3%的受影响患者存在多种自身免疫情况。与这些自身免疫表现最常相关的IEI亚型是常见变异型免疫缺陷(16.7%)。自身免疫表现是摩洛哥患有IEI儿童的常见并发症,以自身免疫性血细胞减少症为主。对于最初表现为自身免疫,特别是自身免疫性血细胞减少症的患者,应保持对IEI的高度怀疑指数。由于这些患者死亡风险较高,需要进行个性化管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/302a/12268102/211eec2b03db/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/302a/12268102/211eec2b03db/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/302a/12268102/211eec2b03db/gr1.jpg

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本文引用的文献

[1]
Autoimmune Cytopenias Are Highly Associated with Inborn Errors of Immunity and They May Be the Initial Presentations in Cases without Severe Infections.

Int Arch Allergy Immunol. 2024

[2]
Genetics of Inborn Errors of Immunity in highly consanguineous Middle Eastern and North African populations.

Semin Immunol. 2023-5

[3]
Primary immunodeficiencies (PID) Life Index in Southeast Asia: A comparative analysis of PID Principles of Care (PoC).

Front Immunol. 2023

[4]
The 2022 Update of IUIS Phenotypical Classification for Human Inborn Errors of Immunity.

J Clin Immunol. 2022-10

[5]
[Consanguineous marriages and their effects on non-communicable diseases in the Moroccan population: a cross-sectional study].

Pan Afr Med J. 2022-3-16

[6]
Inborn Errors of Immunity in Algerian Children and Adults: A Single-Center Experience Over a Period of 13 Years (2008-2021).

Front Immunol. 2022

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J Clin Med. 2021-10-15

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J Clin Immunol. 2021-8

[9]
Initial presenting manifestations in 16,486 patients with inborn errors of immunity include infections and noninfectious manifestations.

J Allergy Clin Immunol. 2021-11

[10]
Autoimmune manifestations among 461 patients with monogenic inborn errors of immunity.

Pediatr Allergy Immunol. 2021-8

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