Diagnostic and Predictive Contribution of Autoantibodies Screening in a Large Series of Patients With Primary Immunodeficiencies

Frontiers in Immunology

Abdalbasset Ketfi¹  Hassen Messaoudi²  Nadia Boukhenfouf³  Mohamed Amine Ifri⁴  Tahar Bencharif Madani⁵  Hayet Belhadj⁶  Keltoum Nafissa Benhala⁷  Mokhtar Khiari⁷  Nacera Cherif⁸  Leila Smati⁹  Sihem Taguemount^1,10  Kamel Djenouhat^1,10  Asma Oukil^1,10  Asma Soufane^1,10  Hamza Iguerguesdaoune^1,10  Azzeddine Tahiat^1,10  Chahinez Boubidi^1,11  Zoulikha Zeroual^1,11  Zakia Arada^1,12  Warda Drali^1,12  Djamila Bouziane^1,13  Ouardia Ibsaine^1,13  Zair Bouzerar^1,14  Souhila Melzi^1,14  Laziz Atek^1,15  Samira Aggoune^1,15  Hachemi Maouche^1,15  Chafa Bendahmane^1,16  Reda Belbouab^1,17  Mohamed Samir Ladj^1,17  Rachida Boukari^1,17  Abdelghani Yagoubi^1,18 

[1] 0Department of Pneumology, Rouiba Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;1Department of Internal Medicine, Mustapha University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;2Department of Pediatrics, Rouiba Hospital, Algiers, Algeria;3Department of Pediatrics, Thenia Hospital, Boumerdes, Algeria;4Department of Pediatrics, Mansourah Hospital, Constantine, Algeria;5Department of Pediatrics, Central Hospital of the Army, Algiers, Algeria;6Department of Pediatrics A, Beni Messous University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;7Department of Pediatrics B, Beni Messous University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;8Department of Pediatrics, Bologhine Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Medical Biology, Rouiba Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics A, Hussein Dey University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics B, Hussein Dey University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics, Ain Taya Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics, Bab El-Oued University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics, El-Harrach Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Department of Pediatrics, Meftah Hospital, Blida, Algeria;Department of Pediatrics, Mustapha University Hospital, Algiers Faculty of Medicine, University of Algiers 1, Algiers, Algeria;Pediatric Gastroenterology, Centre Algérois de Pédiatrie, Algiers, Algeria;

关键词: primary immunodeficiencies;    autoantibody;    screening;    autoimmune cytopenia;    celiac disease;    platelet-bound IgM;   

DOI  :  10.3389/fimmu.2021.665322

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown