Allergic Manifestation in Paediatric Patients with Primary Immunodeficiency Diseases
Keywords:immunodeficiencies, allergy, asthma, atopy, allergic manifestation
Introduction. Primary immunodeficiency diseases (PID) are a diverse group of rare genetic disorders that affect the development and/or function of the immune system. Affected individuals are predisposed to an increased rate and severity of infections, allergy, autoimmunity and malignancy. Primary immunodeficiency diseases are considered rare; physicians and general practitioners have little knowledge about the clinical presentation, diagnostic approach and health impact of PID. Many PID patients have a clinical history in favour of allergic diseases. Nevertheless, in these patients, the importance and prevalence of atopic disorders have not been completely explained.
Aim. The aim of this study was to evaluate atopic presentations, including atopic dermatitis, allergic rhinitis and asthma in a group of PID patients under the care of our clinic.
Material and Methods. Fifty-seven pediatric patients with PID primary immunodeficiency diseases were enrolled from March 2018 to April 2019. Serum IgE levels were measured. Information regarding the patient’s history of allergic diseases, including asthma, allergic rhinitis and atopic dermatitis were analysed.
Results and Conclusions. Confirmed allergy/asthma was found in 40 patients (70%). Thirty-eight patients (66.7%) had a diagnosis of asthma, 7 patients (12.3%) of allergic rhinitis and 13 (22.8%) of atopic dermatitis. Serum IgE total level was elevated in 12 patients (21%).
Soler-Palacín P, de Gracia J, González-Granado LI, Martín C, Rodríguez-Gallego C, Sánchez-Ramón S, Group LI. Primary immunodeficiency diseases in lung disease: warning signs, diagnosis and management. Respiratory Research. 2018 Nov 12;19(1). https://doi.org/10.1186/s12931-018-0923-8
Shields AM, Patel SY. The primary immunodeficiency disorders. Medicine. 2017 Oct;45(10):597-604. https://doi.org/10.1016/j.mpmed.2017.07.011
Mahlaoui N, Gathmann B, Kindle G, Ehl S, ESID Registry Working Party Steering Committee, ESID Society. The European Society for Immunodefciencies (ESID) Registry: recent advancements in the epidemiology of Primary Immunodefciencies and how does that translate in clinical care. Int J Public Health. 2014 Dec;1(4):25-7.
Kobrynski L, Powell RW, Bowen S. Prevalence and Morbidity of Primary Immunodeficiency Diseases, United States 2001–2007. Journal of Clinical Immunology. 2014 Sep 26;34(8):954-961. https://doi.org/10.1007/s10875-014-0102-8
Agondi RC, Barros MT, Rizzo LV, Kalil J, Giavina-Bianchi P. Allergic asthma in patients with common variable immunodeficiency. Allergy. 2010 04;65(4):510-515. https://doi.org/10.1111/j.1398-9995.2009.02211.x
Agondi RC, Barros MT, Kokron CM, Cohon A, Oliveira AK, Kalil J, Giavina-Bianchi P. Can Patients with Common Variable Immunodeficiency Have Allergic Rhinitis?. American Journal of Rhinology & Allergy. 2013 Mar;27(2):79-83. https://doi.org/10.2500/ajra.2013.27.3855
Gernez Y, Freeman AF, Holland SM, Garabedian E, Patel NC, Puck JM, Sullivan KE, Akhter J, Secord E, Chen K, Buckley R, Haddad E, Ochs HD, Fuleihan R, Routes J, Muskat M, Lugar P, Mancini J, Cunningham-Rundles C. Autosomal Dominant Hyper-IgE Syndrome in the USIDNET Registry. The Journal of Allergy and Clinical Immunology: In Practice. 2018 May;6(3):996-1001. https://doi.org/10.1016/j.jaip.2017.06.041
Altun D, Akpınar M, Haskoloğlu ZŞ, Köste Bal S, Kavgacı A, Doğu EF, İkincioğulları KA. Immunoglobulin Isotype Deficiency Together with Allergic Diseases. Asthma Allergy Immunology. 2016 Dec 30;14(3):164-169. https://doi.org/10.21911/aai.6028
Özcan C, Metin A, Erkoçoğlu M, Kocabaş C. Allergic diseases in children with primary immunodeficiencies. Turk J Pediatr. 2014 Jan-Feb;56(1):41-7. PMID 24827946
The Global Initiative for Asthma (GINA), Main Report, 2019. https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-June-2019-wms.pdf
Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R. Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology. 2014 Feb;70(2):338-351. https://doi.org/10.1016/j.jaad.2013.10.010
Small P, Keith PK, Kim H. Allergic rhinitis. Allergy, Asthma & Clinical Immunology. 2018 Sep;14(S2). https://doi.org/10.1186/s13223-018-0280-7
Mantis N, Rol N, Corthésy B. Secretory IgA's complex roles in immunity and mucosal homeostasis in the gut. Mucosal Immunology. 2011 Oct 5;4(6):603-611. https://doi.org/10.1038/mi.2011.41
Szczawinska-Poplonyk A. An Overlapping Syndrome of Allergy and Immune Deficiency in Children. Journal of Allergy. 2012;2012:1-9. https://doi.org/10.1155/2012/658279
Dadkhah M, Aghamohammadi A, Movahedi M, Gharagozlou M. Atopic Manifestations: Dermatitis, Allergic Rhinitis and Asthma in Patients With Hypogammaglobulinemia. Iranian Journal of Pediatrics. 2015 Oct 6;25(5). https://doi.org/10.5812/ijp.2786
Berger M, Geng B, Cameron DW, Murphy LM, Schulman ES. Primary immune deficiency diseases as unrecognized causes of chronic respiratory disease. Respiratory Medicine. 2017 Nov;132:181-188. https://doi.org/10.1016/j.rmed.2017.10.016
Baleeiro C, Mull N. Prevalence Of Common Variable Immunodeficiency (CVID) Among Patients With Recurrent Respiratory Tract Infections. B49. BRONCHIECTASIS: CYSTIC FIBROSIS AND BEYOND. American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. 2010 May. https://doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3187
Postma DS, Rabe KF. The Asthma–COPD Overlap Syndrome. Drazen JM. New England Journal of Medicine. 2015 Sep 24;373(13):1241-1249. https://doi.org/10.1056/nejmra1411863
Penders J, Kummeling I, Thijs C. Infant antibiotic use and wheeze and asthma risk: a systematic review and meta-analysis. European Respiratory Journal. 2011 Jan 13;38(2):295-302. https://doi.org/10.1183/09031936.00105010
Ying S, Humbert M, Meng Q, Pfister R, Menz G, Gould HJ, Kay A, Durham SR. Local expression of ϵ germline gene transcripts and RNA for the ϵ heavy chain of IgE in the bronchial mucosa in atopic and nonatopic asthma. Journal of Allergy and Clinical Immunology. 2001 Apr;107(4):686-692. https://doi.org/10.1067/mai.2001.114339
Pichard DC, Freeman AF, Cowen EW. Primary immunodeficiency update. Journal of the American Academy of Dermatology. 2015 Sep;73(3):355-364. https://doi.org/10.1016/j.jaad.2015.01.054
Moin A, Farhoudi A, Moin M, Pourpak Z, Bazargan N. Cutaneous manifestations of primary immunodeficiency diseases in children. Iran J Allergy Asthma Immunol. 2006 Sep;5(3):121-6. PMID 17237563
de Wit J, Brada RJK, van Veldhuizen J, Dalm VASH, Pasmans SGMA. Skin disorders are prominent features in primary immunodeficiency diseases: A systematic overview of current data. Allergy. 2018 Dec 27;74(3):464-482. https://doi.org/10.1111/all.13681
Urschel S, Kayikci L, Wintergerst U, Notheis G, Jansson A, Belohradsky BH. Common Variable Immunodeficiency Disorders in Children: Delayed Diagnosis Despite Typical Clinical Presentation. The Journal of Pediatrics. 2009 Jun;154(6):888-894. https://doi.org/10.1016/j.jpeds.2008.12.020
Mohammadinejad P, Aghamohammadi A, Abolhassani H, Sadaghiani M, Abdollahzade S, Sadeghi B, Soheili H, Tavassoli M, Fathi S, Tavakol M, Behniafard N, Darabi B, Pourhamdi S, Rezaei N. Pediatric patients with common variable immunodeficiency: long-term follow-up. J Investig Allergol Clin Immunol. 2012;22(3):208-14. PMID 22697011
How to Cite
Copyright (c) 2020 Joanna Pawłowska, Agnieszka Sobocińska, Izabela Kałuzińska-Parzyszek, Joanna Jerzyńska, Agnieszka Brzozowska
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.