Inborn Errors of Immunity in Pediatric Intensive Care: Prevalence, Characteristics, and Prognosis


Celmeli F., Oz A., Kihtir H. S., Ongun E. A., Tekmenuray-Unal A., CEYLANER S., ...Daha Fazla

Journal of Clinical Immunology, cilt.45, sa.1, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 45 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s10875-024-01823-5
  • Dergi Adı: Journal of Clinical Immunology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, Veterinary Science Database
  • Anahtar Kelimeler: Combined immunodeficiencies, Immune dysregulation, Inborn errors of immunity, Outcomes, PICU
  • Marmara Üniversitesi Adresli: Evet

Özet

Inborn errors of immunity (IEI) are a heterogeneous group of genetic diseases characterized by impaired immune system function. This prospective study aimed to determine the frequency, characteristics, and clinical course of IEI patients admitted to the pediatric intensive care unit (PICU) and identify mortality-related factors. Using a comprehensive immunological evaluation protocol, we screened 753 PICU admissions for potential IEIs during three years. Patients with pre-existing IEI diagnoses, chronic diseases, ongoing chronic medication regimens, other known comorbidities, trauma cases, post-surgical cases, and poisonings were excluded. Thirty-three patients were newly diagnosed with IEIs during or as a result of their PICU stay, representing an incidence of 4.39%. The most common disorders were immunodeficiencies with immune dysregulation (48.5%), followed by combined immunodeficiencies (24.2%). Severe viral infections (61%) and life-threatening infections (51.7%) were the most frequent warning signs. Only 31% of patients exhibited at least two Jeffrey Modell Foundation warning signs. The mortality rate was 58%, highlighting the need for early diagnosis and treatment. Newborn screening and family segregation studies are crucial to improving outcomes for IEI patients in intensive care settings.