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Published in: Inflammation Research 10-12/2021

01-12-2021 | Primary Immunodeficiency | Original Research Paper

Analysis of five cases of monogenic lupus related to primary immunodeficiency diseases

Authors: Gaixiu Su, Jianming Lai, Jia Zhu, Dan Zhang, Jun Hou, Yingjie Xu, Zhixuan Zhou

Published in: Inflammation Research | Issue 10-12/2021

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Abstract

Objective and design

We studied five cases of PID-related monogenic lupus to explore the characteristics.

Material or subjects

Among 42 cases of PID patients between 2017–2020, 5 patients were diagnosed as PID-related monogenic lupus, including 2 males and 3 females, with age range from 2 years 3 months to 13 years old.

Treatments

DMARDs, biological agents and stem cell transplantation were used to treat different patients.

Methods

We collected the clinical observation indicators, auxiliary examination and treatment of the five patients.

Results

Patient 1 was diagnosed with monogenic lupus secondary to severe combined immunodeficiency and received prednisone and methotrexate treatment. Patient 2 was diagnosed with monogenic lupus secondary to activated phosphoinositide 3-kinase δ syndrome. Allogeneic stem cell transplantation was conducted. Patient 3 was diagnosed with monogenic lupus secondary to RAS‐associated lymphoproliferative disease. The child was treated with prednisone and rituximab. Patient 4 was diagnosed with monogenic lupus secondary to PSTPIP1-associated myeloid-related proteinaemia inflammatory syndrome. The child was given methylprednisolone, methotrexate, and infliximab. Patient 5 was diagnosed with monogenic lupus secondary to A20 haploinsufficiency. The child was treated with methylprednisolone and infliximab.

Conclusions

Multiple PIDs can lead to monogenic lupus. Different PID-related monogenic lupus has different suitable targeted drugs.
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Literature
1.
go back to reference Errante PR, Perazzio SF, Frazao JB, et al. Primary Immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a teriary university hospital at Sao Paulo, Brazil. Rev Bras Reumatol. 2016;56(1):58–68.CrossRef Errante PR, Perazzio SF, Frazao JB, et al. Primary Immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a teriary university hospital at Sao Paulo, Brazil. Rev Bras Reumatol. 2016;56(1):58–68.CrossRef
2.
go back to reference Tangye SG, Al-Herz W, Bousfiha A, et al. Human inborn errors of immunity: 2019 update on the classification from the international union of immunological societies expert committee. J Clin Immunol. 2020;40:24–64.CrossRef Tangye SG, Al-Herz W, Bousfiha A, et al. Human inborn errors of immunity: 2019 update on the classification from the international union of immunological societies expert committee. J Clin Immunol. 2020;40:24–64.CrossRef
4.
go back to reference Almlöf JC, Nystedt S, Leonard D, Eloranta ML, Grosso G, Sjöwall C, Bengtsson AA, Jönsen A, Gunnarsson I, Svenungsson E, et al. Whole-genome sequencing identifies complex contributions to genetic risk by variants in genes causing monogenic systemic lupus erythematosus. Hum Genet. 2019;138(2):141–50 (Epub 2019 Feb 1).CrossRef Almlöf JC, Nystedt S, Leonard D, Eloranta ML, Grosso G, Sjöwall C, Bengtsson AA, Jönsen A, Gunnarsson I, Svenungsson E, et al. Whole-genome sequencing identifies complex contributions to genetic risk by variants in genes causing monogenic systemic lupus erythematosus. Hum Genet. 2019;138(2):141–50 (Epub 2019 Feb 1).CrossRef
6.
go back to reference Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725–6.CrossRef Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725–6.CrossRef
7.
go back to reference Petri M, Orbai AM, Alarcon GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.CrossRef Petri M, Orbai AM, Alarcon GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.CrossRef
9.
go back to reference Chen K, Wu W, Mathew D, Zhang Y, Browne SK, Rosen LB, McManus MP, Pulsipher MA, Yandell M, Bohnsack JF, et al. Autoimmunity due to RAG deficiency and estimated disease incidence in RAG1/2 mutations. J Allergy Clin Immunol. 2014;133:880-882.e810 (CrossRef PubMed).CrossRef Chen K, Wu W, Mathew D, Zhang Y, Browne SK, Rosen LB, McManus MP, Pulsipher MA, Yandell M, Bohnsack JF, et al. Autoimmunity due to RAG deficiency and estimated disease incidence in RAG1/2 mutations. J Allergy Clin Immunol. 2014;133:880-882.e810 (CrossRef PubMed).CrossRef
10.
go back to reference Walter JE, Lo MS, Kis-Toth K, Tirosh I, Frugoni F, Lee YN, et al. Impaired receptor editing and heterozygous RAG2 mutation in a patient with systemic lupus erythematosus and erosive arthritis. J Allergy Clin Immunol. 2015;135:272–3.CrossRef Walter JE, Lo MS, Kis-Toth K, Tirosh I, Frugoni F, Lee YN, et al. Impaired receptor editing and heterozygous RAG2 mutation in a patient with systemic lupus erythematosus and erosive arthritis. J Allergy Clin Immunol. 2015;135:272–3.CrossRef
11.
go back to reference Coulter TI, Chandra A, Bacon CM, et al. Clinical spectrum and features of activated phosphoinositide 3-kinaseδsyndrome: a large cohort study. Allergy Clin Immunol. 2017;139(2):597–606.CrossRef Coulter TI, Chandra A, Bacon CM, et al. Clinical spectrum and features of activated phosphoinositide 3-kinaseδsyndrome: a large cohort study. Allergy Clin Immunol. 2017;139(2):597–606.CrossRef
15.
go back to reference Aeschlimann FA, Batu ED, Canna SW, Go E, Gül A, Hoffmann P, Leavis HL, Ozen S, Schwartz DM, Stone DL, van Royen-Kerkof A, Kastner DL, Aksentijevich I, Laxer RM. A20 haploinsufficiency (HA20): clinical phenotypes and disease course of patients with a newly recognised NF-kB-mediated autoinflammatory disease. Ann Rheum Dis. 2018;77(5):728–35. https://doi.org/10.1136/annrheumdis-2017-212403.CrossRefPubMed Aeschlimann FA, Batu ED, Canna SW, Go E, Gül A, Hoffmann P, Leavis HL, Ozen S, Schwartz DM, Stone DL, van Royen-Kerkof A, Kastner DL, Aksentijevich I, Laxer RM. A20 haploinsufficiency (HA20): clinical phenotypes and disease course of patients with a newly recognised NF-kB-mediated autoinflammatory disease. Ann Rheum Dis. 2018;77(5):728–35. https://​doi.​org/​10.​1136/​annrheumdis-2017-212403.CrossRefPubMed
16.
go back to reference Kadowaki T, Ohnishi H, Kawamoto N, Hori T, Nishimura K, Kobayashi C, Shigemura T, Ogata S, Inoue Y, Kawai T, Hiejima E, Takagi M, Imai K, Nishikomori R, Ito S, Heike T, Ohara O, Morio T, Fukao T, Kanegane H. Haploinsufficiency of A20 causes autoinflammatory and autoimmune disorders. J Allergy Clin Immunol. 2018;141(4):1485-1488.e11. https://doi.org/10.1016/j.jaci.2017.10.039.CrossRefPubMed Kadowaki T, Ohnishi H, Kawamoto N, Hori T, Nishimura K, Kobayashi C, Shigemura T, Ogata S, Inoue Y, Kawai T, Hiejima E, Takagi M, Imai K, Nishikomori R, Ito S, Heike T, Ohara O, Morio T, Fukao T, Kanegane H. Haploinsufficiency of A20 causes autoinflammatory and autoimmune disorders. J Allergy Clin Immunol. 2018;141(4):1485-1488.e11. https://​doi.​org/​10.​1016/​j.​jaci.​2017.​10.​039.CrossRefPubMed
17.
go back to reference Rao VK, Dugan F, Dale JK, et al. Use of mycophenolate mofetil for chronic, refractory immune cyLopenias in children with auloim-mune lymphoproliferative syndrome. Br J Haemat. 2005;01(129):534–8. Rao VK, Dugan F, Dale JK, et al. Use of mycophenolate mofetil for chronic, refractory immune cyLopenias in children with auloim-mune lymphoproliferative syndrome. Br J Haemat. 2005;01(129):534–8.
18.
go back to reference Teachey DT, Creiner R, Seif A, et al. Treatment with sirolimus results in complete responses in patients with autoimmune lympho-proliferative syndrome. Br J Haemat. 2009;01(145):101–6.CrossRef Teachey DT, Creiner R, Seif A, et al. Treatment with sirolimus results in complete responses in patients with autoimmune lympho-proliferative syndrome. Br J Haemat. 2009;01(145):101–6.CrossRef
19.
go back to reference Cooper N, Davies EC, Thrasher AJ. Repeated courses of rituximab for autoimmune cytopenias may precipitate profound hypoga-mmaglobulinaemia requiring replacement intravenous immunoglobulin. Br J Haematol. 2009;146:120–2.CrossRef Cooper N, Davies EC, Thrasher AJ. Repeated courses of rituximab for autoimmune cytopenias may precipitate profound hypoga-mmaglobulinaemia requiring replacement intravenous immunoglobulin. Br J Haematol. 2009;146:120–2.CrossRef
Metadata
Title
Analysis of five cases of monogenic lupus related to primary immunodeficiency diseases
Authors
Gaixiu Su
Jianming Lai
Jia Zhu
Dan Zhang
Jun Hou
Yingjie Xu
Zhixuan Zhou
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Inflammation Research / Issue 10-12/2021
Print ISSN: 1023-3830
Electronic ISSN: 1420-908X
DOI
https://doi.org/10.1007/s00011-021-01479-6

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