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ObjectivesTo evaluate the diagnostic and predictive contribution of autoantibodies screening in patients with primary immunodeficiencies (PIDs).MethodsIn the present study, PID patients and healthy controls have been screened for 54 different autoantibodies. The results of autoantibodies screening in PID patients were correlated to the presence of autoimmune diseases.ResultsA total of 299 PID patients were included in this study with a predominance of antibody deficiencies (27.8%) followed by immunodeficiencies affecting cellular and humoral immunity (26.1%) and complement deficiencies (22.7%). Autoimmune manifestations were present in 82 (27.4%) patients. Autoimmune cytopenia (10.4%) was the most common autoimmune disease followed by gastrointestinal disorders (10.0%), rheumatologic diseases (3.7%), and endocrine disorders (3.3%). Autoantibodies were found in 32.4% of PID patients and 15.8% of healthy controls (P < 0.0005). Anti-nuclear antibodies (ANA) (10.0%), transglutaminase antibody (TGA) (8.4%), RBC antibodies (6.7%), anti-smooth muscle antibody (ASMA) (5.4%), and ASCA (5.0%) were the most common autoantibodies in our series. Sixty-seven out of the 82 patients with autoimmune manifestations (81.7%) were positive for one or more autoantibodies. Eleven out of the 14 patients (78.6%) with immune thrombocytopenia had positive platelet-bound IgM. The frequencies of ASCA and ANCA among patients with IBD were 47.4% and 21.0% respectively. All patients with celiac disease had TGA-IgA, while six out of the 11 patients with rheumatologic diseases had ANA (54.5%). Almost one third of patients (30/97) with positive autoantibodies had no autoimmune manifestations. ANA, rheumatoid factor, ASMA, anti-phospholipid antibodies and ANCA were often detected while specific AID was absent. Despite the low positive predictive value of TGA-IgA and ASCA for celiac disease and inflammatory bowel disease respectively, screening for these antibodies identified undiagnosed disease in four patients with positive TGA-IgA and two others with positive ASCA.ConclusionThe present study provides valuable information about the frequency and the diagnostic/predictive value of a large panel of autoantibodies in PIDs. Given the frequent association of some AIDs with certain PIDs, screening for corresponding autoantibodies would be recommended. However, positivity for autoantibodies should be interpreted with caution in patients with PIDs due to their low positive predictive value.

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Introduction: Helicobacter pylori (H. pylori) is a pathogen which is capable of colonizing the gastric mucosa and is associated with some pathological changes that may lead to dyspeptic manifestations. Recently, H. pylori was found to be present in the oral cavity and there was a growing body of evidence that the organism is linked to some dental diseases such as periodontitis and gingivitis. Materials and Method: In this study, 123 patients were investigated to explore the possible relationship between the presence of oral H. pylori and gastric dyspepsia. Patients were classified into oral disease group (viz. gingivitis and periodontitis) or gastric disease group (viz. gastritis, gastric ulcer, and duodenal ulcer). A third group had neither had oral nor gastric disease. Based on the presence or absence of H. pylori, patients were also classified as having either oral, gastric, or both oral and gastric organism. Some of the patients were neither having oral nor gastric infection. Results: 59 patients showed the presence of H. pylori in the gastro-duodenal area, 7 showed presence of oral H. pylori, whereas 18 patients showed H. pylori in both gastroduodenal and oral specimens. Differences between groups were not statistically significant. Conclusions: Although there was a suggestion of a clinical and laboratory evidence of an association between the presence of oral H. pylori and the studied gastric diseases, this association was not statistically significant.