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Analysis of five cases of monogenic lupus related to primary immunodeficiency diseases
Gaixiu Su1, Jianming Lai2, Jia Zhu1
1Department of Rheumatology and Immunology, Capital Institute of Pediatrics, No.2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Objective And Design:
We studied five cases of PID-related monogenic lupus to explore the characteristics.
Material Or Subjects:
Among 42 cases of PID patients between 2017-2020, 5 patients were diagnosed as PID-related monogenic lupus, including 2 males and 3 females, with age range from 2 years 3 months to 13 years old.
Treatments:
DMARDs, biological agents and stem cell transplantation were used to treat different patients.
Methods:
We collected the clinical observation indicators, auxiliary examination and treatment of the five patients.
Results:
Patient 1 was diagnosed with monogenic lupus secondary to severe combined immunodeficiency and received prednisone and methotrexate treatment. Patient 2 was diagnosed with monogenic lupus secondary to activated phosphoinositide 3-kinase δ syndrome. Allogeneic stem cell transplantation was conducted. Patient 3 was diagnosed with monogenic lupus secondary to RAS-associated lymphoproliferative disease. The child was treated with prednisone and rituximab. Patient 4 was diagnosed with monogenic lupus secondary to PSTPIP1-associated myeloid-related proteinaemia inflammatory syndrome. The child was given methylprednisolone, methotrexate, and infliximab. Patient 5 was diagnosed with monogenic lupus secondary to A20 haploinsufficiency. The child was treated with methylprednisolone and infliximab.
Conclusions:
Multiple PIDs can lead to monogenic lupus. Different PID-related monogenic lupus has different suitable targeted drugs.
Insights
Primary immunodeficiencies (PIDs) can manifest as monogenic lupus. Tailored treatments, including targeted therapies and stem cell transplantation, are crucial for managing these rare conditions.
Area of Science:
- Immunology
- Genetics
- Pediatrics
Background:
- Primary immunodeficiencies (PIDs) are a group of genetic disorders affecting the immune system.
- Monogenic lupus is a rare autoimmune condition with a known genetic cause.
Observation:
- This study analyzed five pediatric cases of PID-related monogenic lupus diagnosed between 2017-2020.
- Patients presented with diverse PIDs, including severe combined immunodeficiency, phosphoinositide 3-kinase delta syndrome, and A20 haploinsufficiency.
Findings:
- Monogenic lupus can be a secondary manifestation of various PIDs.
- Treatment approaches varied, including immunosuppressants (prednisone, methotrexate, rituximab, infliximab) and allogeneic stem cell transplantation.
Implications:
- Understanding the genetic basis of PIDs is essential for diagnosing monogenic lupus.
- Personalized treatment strategies targeting specific PIDs are critical for effective management and improved outcomes.
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