Managing patients with side effects and adverse events to immunoglobulin therapy

Azizi, Gholamreza; Abolhassani, Hassan; Asgardoon, Mohammad Hossein; Shaghaghi, Shiva; Negahdari, Babak; Mohammadi, Javad; Rezaei, Nima; Aghamohammadi, Asghar

doi:10.1586/17512433.2016.1105131

Cited by 23 publications

(28 citation statements)

References 86 publications

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“…Therefore, due to decreased Ig synthesis and lack of autoantibodies as well as unusual pattern of biopsy in patient with CVID, a physical examination performed by an experienced rheumatologist and imaging methods such as X‐rays and magnetic resonance imaging (MRI) scans are helpful for making the diagnosis and evaluation of rheumatologic disorders. Also, other complementary methods including human leucocyte antigen (HLA) typing, microbial assays, synovial fluid analysis and biopsy can help to the judgement of rheumatologists; however, some of these methods are still not recommended for use in clinical setting and does not confirm the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, rheumatologic complications can be the presenting symptom of immunodeficiency prior to the definite diagnosis of CVID, particularly when accompanied by infectious and inflammatory/autoimmune complications. Due to the complexity of the conditions of the CVID, examination by an experienced rheumatologist and more advanced paraclinical investigations play a key role in the diagnosis and management of rheumatologic diseases in these patients …”

Section: Discussionmentioning

confidence: 99%

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Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency

et al. 2018

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Common variable immunodeficiency (CVID) is the most prevalent symptomatic type of human primary immunodeficiency diseases (PID). Clinically, CVID is characterized by increased susceptibility to infections and a wide variety of autoimmune and rheumatologic disorders. All patients with CVID registered in Iranian PID Registry (IPIDR) were enrolled in this retrospective cohort study. We investigated the frequency of rheumatologic diseases and its association with immunological and clinical phenotypes in patients with CVID. A total of 227 patients with CVID were enrolled in this study. The prevalence of rheumatologic disorders was 10.1% with a higher frequency in women than men. Most common rheumatologic manifestations were juvenile idiopathic arthritis (JIA) and adult rheumatoid arthritis (RA) followed by juvenile spondyloarthritis (JSpA) and undifferentiated inflammatory arthritis (UIA). Septic arthritis in patients with CVID with a history of RA and JIA was higher than patients without rheumatologic complication. Patients with CVID with a history of autoimmunity (both rheumatologic and non-rheumatologic autoimmunity) had lower regulatory T cells counts in comparison with patients without autoimmune disorders. There was an association between defect in specific antibody responses and negative serologic test results in patients with rheumatologic manifestations. JIA, RA, JSpA and UIA are the most frequent rheumatologic disorders in patients with CVID. Due to antibody deficiency, serologic tests may be negative in these patients. Therefore, these conditions pose significant diagnostic and therapeutic challenges for immunologists and rheumatologists in charge of the care for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency

et al. 2018

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“…Pulmonary adverse effects associated with immunoglobulin therapy can be classed as immediate reactions (flu-like symptoms, hypersensitivity reaction, and transfusion-related acute lung injury) and delayed reactions (mainly due to thromboembolic events) [128].…”

Section: Pulmonary Complications Of Pid Treatmentmentioning

confidence: 99%

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Yazdani

Abolhassani

et al. 2017

J Investig Allergol Clin Immunol

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Primary immunodeficiency disorders (PIDs) are caused by 1 or more defects of the immune system. Patients are more likely to experience recurrent and/or severe infections and tend to develop a wide range of complications. Respiratory diseases are the main and initial manifestation in most cases and the most common complication. Pulmonary complications cause significant morbidity and mortality in patients with PIDs. Early diagnosis and appropriate treatment can prevent or at least slow the development of respiratory complications. Since the spectrum of pulmonary complications in PIDs is broad, we divided pulmonary complications into upper respiratory complications (eg, sinusitis, otitis media, and laryngeal angioedema) and lower respiratory complications (eg, pneumonia, bronchitis, bronchiectasis, interstitial lung diseases, organizing pneumonia, pulmonary adenopathies and malignancies, hyperreactive airway diseases, pulmonary dysgenesis, and adverse reactions to treatment). This review covers the main respiratory manifestations in patients with PIDs. Key words: Primary immunodeficiency disorders. Pulmonary complications. Upper respiratory tract. Lower respiratory tract. ResumenLas inmunodeficiencias primarias (PIDs) son enfermedades causadas por uno o más defectos del sistema inmunológico. Estos pacientes presentan con frecuencia infecciones recidivantes y/o severas así como otro tipo de complicaciones. Las patologías respiratorias son la principal y más frecuente manifestación y complicación de las PIDs. Las complicaciones de estas patologías pulmonares constituyen una de las principales causas de morbimortalidad entre los pacientes que sufren PIDs. El diagnóstico temprano y el tratamiento adecuado pueden prevenir, o al menos retrasar, la aparición de las complicaciones respiratorias en estos pacientes. Dado que el espectro de las enfermedades pulmonares es muy amplio, hemos dividido estas complicaciones entre aquellas que afectan a las vías aéreas superiores (sinusitis, otitis media y angioedema laríngeo, etc.) y las que afectan a las vías aéreas bajas (neumonía, bronquitis, bronquiectasias, enfermedades pulmonares intersticiales, neumonía organizada, adenopatías pulmonares y neoplasias, hiperreactividad bronquial, disgenesia pulmonar y las debidas a los efectos secundarios del tratamiento instaurado). Este artículo revisa las manifestaciones respiratorias que se observan más frecuentemente en los pacientes con PIDs. Palabras clave: Inmunodeficiencias primarias. Complicaciones pulmonares. Vías respiratorias altas. Vías respiratorias bajas.

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“…However, some cases may be characterized with recurrent infections, allergic conditions, and autoimmune complications [8,98,99,100]. Since 30% of sIgAD patients have considerable titers of IgG antibodies against IgA, a breakdown of tolerance against IgA itself or against other factors that contribute to the class switching process, such as TACI, APRIL, and BAFF, probably accounts for the pathophysiological mechanism [101,102,103,104]. Evidence in support of this hypothesis includes that the pathogenesis of sIgAD is an autoimmune process [105].…”

Section: Autoimmunity In Padsmentioning

confidence: 99%

Autoimmunity in Primary Antibody Deficiencies

Azizi¹,

Ahmadi²,

Abolhassani³

et al. 2016

Int Arch Allergy Immunol

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Primary antibody deficiencies (PADs) are the most common inherited primary immunodeficiencies in humans, characterized by hypogammaglobulinemia, an inability to produce specific antibodies, and recurrent infections mainly caused by encapsulated bacteria. However, it has been shown that inflammatory disorders, granulomatous lesions, lymphoproliferative diseases, cancer, and autoimmunity are associated with the various types of PAD. Both systemic and organ-specific autoimmune diseases could be attributed to B-cell defects in PAD patients. Immune thrombocytopenic purpura and autoimmune hemolytic anemia are the most common autoimmune disorders in this group of patients. The aim of this review is to describe the proposed mechanisms for autoimmunity and to review the literature with respect to the reported autoimmune disorders in each type of PAD.

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Managing patients with side effects and adverse events to immunoglobulin therapy

Cited by 23 publications

References 86 publications

Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency

Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Autoimmunity in Primary Antibody Deficiencies

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