Clinical and immunological features of common variable immunodeficiency in Mexican patients

Ramírez-Vargas, Nadia Gisela; Arablin-Oropeza, S.E.; Mojica-Martínez, D.; Yamazaki‐Nakashimada, Marco Antonio; García-Cruz, María de la Luz Hortensia; Teran-Juárez, Luis Manuel; Cortes-Grimaldo, Rosa Maria; Torres-Lozano, Carlos; Madrigal-Beas, I.; Ortega-Cisneros, Margarita; Vargas-Camaño, María Eugenia; Staines-Boone, Tamara; Pietropaolo-Cienfuegos, Dino; Berrón-Ruíz, Laura; Espinosa-Rosales, Francisco; Guevara‐Cruz, Martha; Blancas-Galicia, Lizbeth

doi:10.1016/j.aller.2013.01.007

Cited by 38 publications

(33 citation statements)

References 13 publications

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“…Although the diversity of autoimmune conditions in the present IgGSD patients was greater than that of CVID patients, no CVID patient and only one IgGSD patient had hemocytopenia attributed to autoimmunity. This result differs from that of other CVID case series reports [2, 24, 34–36]. Autoimmunity in CVID patients with the more common phenotype characterized by infections may also differ from that of patients who have the less common phenotype associated with polyclonal lymphocytic manifestations [24, 35].…”

Section: Discussioncontrasting

confidence: 63%

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Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients

Bertoli

Barton

2014

Journal of Immunology Research

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Common variable immunodeficiency (CVID) and immunoglobulin (Ig) G subclass deficiency (IgGSD) are heterogeneous disorders characterized by respiratory tract infections, selective Ig isotype deficiencies, and impaired antibody responses to polysaccharide antigens. Using univariable analyses, we compared observations in 34 CVID and 398 IgGSD adult index patients (81.9% women) referred to a hematology/oncology practice. Similarities included specialties of referring physicians, mean ages, proportions of women, reactivity to Pneumovax, median serum IgG3 and IgG4 levels, median blood CD56+/CD16+ lymphocyte levels, positivity for HLA-A and -B types, and frequencies of selected HLA-A, -B haplotypes. Dissimilarities included greater prevalence of autoimmune conditions, lower median IgG, IgA, and IgM, and lower median CD19+, CD3+/CD4+, and CD3+/CD8+ blood lymphocytes in CVID patients. Prevalence of Sjögren's syndrome and hypothyroidism was significantly greater in CVID patients. Combined subnormal IgG1/IgG3 occurred in 59% and 29% of CVID and IgGSD patients, respectively. Isolated subnormal IgG3 occurred in 121 IgGSD patients (88% women). Logistic regression on CVID (versus IgGSD) revealed a significant positive association with autoimmune conditions and significant negative associations with IgG1, IgG3, and IgA and CD56+/CD16+ lymphocyte levels, but the odds ratio was increased for autoimmune conditions alone (6.9 (95% CI 1.3, 35.5)).

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Section: Discussioncontrasting

confidence: 63%

“…Analyzing follow-up observations of patients for the diagnosis of other autoimmune conditions was beyond the scope of the present work. In other CVID case series, 12–46% of patients had autoimmune conditions [2, 24, 34–36]. Autoimmune conditions occurred in 37% of the present IgGSD patients and in 13% of adults with IgGSD in Spain [5].…”

Section: Discussionmentioning

confidence: 78%

Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients

Bertoli

Barton

2014

Journal of Immunology Research

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“…In our study, the diagnostic delay was shorter than that reported in a survey performed in 2013 at several hospitals in Mexico City [15], or the one reported in the 2007 third national survey for PID in USA [14], 2.17 vs. 12.5 vs. 12.4 years. However, in a recently reported survey at the National Institute of Pediatrics in Mexico City, and another one conducted in 2012 in Korea, the time of diagnostic delay was only of 22 and 19 months respectively [16,17].…”

Section: Discussioncontrasting

confidence: 54%

Disease burden for patients with primary immunodeficiency diseases identified at reference hospitals in Guanajuato, Mexico

et al. 2017

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BackgroundIn addition to the deleterious effect on health, there is considerable economic and psychosocial morbidity associated with primary immunodeficiency diseases (PID). Also, the cost of a late diagnosis frequently results in a heavy disease burden on the patient. The objective of this study was to collect and analyze data on patients with PID in the state of Guanajuato in Mexico, to indirectly estimate the burden of the disease.MethodsAn observational, longitudinal, and comparative study was conducted. A total of 44 patients were included and grouped according to the updated classification of PID.ResultsThe median time elapsed from the onset of symptoms to the reference and diagnosis by a tertiary hospital was of 2.17 (IQR = 6.44) years. Before diagnosis, the number of hospitalizations/year per patient was 0.86 (IQR = 2.28), the number of visit to emergency room/year per patient was 0.92 (IQR = 1.77), the number of doctor’s visits/year per patient was 15 (IQR = 11.25), whereas the school/work absence days per patient were reported in 52.72 (IQR = 56.35) days per year. After diagnosis, 20 patients (45.45%) received IVIG replacement therapy, and all of them presented a significant improvement (p <0.05) in all the mentioned variables. Characteristically, even when patients with PID received IVIG, there was still an important disease burden when comparing them against healthy controls. Complications secondary to PID were detected in 19 patients (43.18%). The reported overall mortality rate was 6.82% (n = 3).ConclusionsWe were able to indirectly estimate an important disease burden in patients with PID; which is considered to be preventable, at least in part, with effective interventions like health planning, research, collaboration with primary care providers, and generation of policies and practices, in order to improve the quality of life and care of families with PID.

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“…[9]. In this study, the average time between the onset of PID symptoms and diagnosis was 6.21 years, shorter than that previously described in the literature, i.e., 12.5 years (in the last decade) [10,11]. The presence of a reference unit in clinical immunology with regional coverage may have influenced the reduction of the average time to the diagnosis of PID.…”

Section: Discussionmentioning

confidence: 67%

Sensitization to Aeroallergens in Patients with Primary Immunodeficiencies

Segundo¹,

Canabrava²

2018

Int Arch Allergy Immunol

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Background: Primary immunodeficiencies (PID) are a heterogeneous group of diseases that cause alterations in the immune system, leading to the increased susceptibility to infections, autoimmune diseases, and malignancies. The aim was to evaluate the presence of clinical manifestations and diagnoses of asthma, rhinitis, and atopic dermatitis in patients diagnosed with PID, and correlate these with allergen sensitization verified by skin prick testing (SPT). Material and Methods: This cross-sectional, descriptive, and observational study was conducted from February 2015 to February 2016. We performed a medical report analysis and SPT for aeroallergens in patients with a PID diagnosis. Results: Thirty-one patients with a PID diagnosis were included. The mean age of the participants was 15.41 years. From the 31 patients, 28 had symptoms suggestive of allergic disease (asthma, rhinitis, and atopic dermatitis) and only 7 presented positive SPT for at least 1 aeroallergen. Conclusion: The frequency of allergenic sensitization in the group of patients with PID and symptoms suggestive of asthma, rhinitis, or atopic dermatitis is lower than that found in the general population, probably due the impairment of IgE formation secondary to their immunologic alterations.

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Clinical and immunological features of common variable immunodeficiency in Mexican patients

Cited by 38 publications

References 13 publications

Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients

Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients

Disease burden for patients with primary immunodeficiency diseases identified at reference hospitals in Guanajuato, Mexico

Sensitization to Aeroallergens in Patients with Primary Immunodeficiencies

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