Diagnostic and Predictive Contribution of Autoantibodies Screening in a Large Series of Patients With Primary Immunodeficiencies.
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| Abstract | Objectives: To evaluate the diagnostic and predictive contribution of autoantibodies screening in patients with primary immunodeficiencies (PIDs). Methods: In 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. Results: A 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. Conclusion: The 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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| Authors | Azzeddine Tahiat, Abdelghani Yagoubi, Mohamed Samir Ladj, Reda Belbouab, Samira Aggoune, Laziz Atek, Djamila Bouziane, Souhila Melzi, Chahinez Boubidi, Warda Drali, Chafa Bendahmane, Hamza Iguerguesdaoune, Sihem Taguemount, Asma Soufane, Asma Oukil, Abdalbasset Ketfi, Hassen Messaoudi, Nadia Boukhenfouf, Mohamed Amine Ifri, Tahar Bencharif Madani, Hayet Belhadj, Keltoum Nafissa Benhala, Mokhtar Khiari, Nacera Cherif, Leila Smati, Zakia Arada, Zoulikha Zeroual, Zair Bouzerar, Ouardia Ibsaine, Hachemi Maouche, Rachida Boukari, Kamel Djenouhat |
| Journal | Frontiers in immunology (Front Immunol) Vol. 12 Pg. 665322 ( 2021) ISSN: 1664-3224 [Electronic] Switzerland |
| PMID | 33868317 (Publication Type: Journal Article) |
| Copyright | Copyright © 2021 Tahiat, Yagoubi, Ladj, Belbouab, Aggoune, Atek, Bouziane, Melzi, Boubidi, Drali, Bendahmane, Iguerguesdaoune, Taguemount, Soufane, Oukil, Ketfi, Messaoudi, Boukhenfouf, Ifri, Bencharif Madani, Belhadj, Benhala, Khiari, Cherif, Smati, Arada, Zeroual, Bouzerar, Ibsaine, Maouche, Boukari and Djenouhat. |
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