World Allergy Organization Journal (Jun 2022)
Allergic manifestations of inborn errors of immunity and their impact on the diagnosis: A worldwide study
- Zeinab A. El-Sayed, MD, PhD,
- Dalia H. El-Ghoneimy, MD, PhD,
- José A. Ortega-Martell, MD,
- Nesrine Radwan, MD, PhD,
- Juan C. Aldave, MD,
- Waleed Al-Herz, MD,
- Maryam A. Al-Nesf, MD, ABHS,
- Antonio Condino-Neto, MD, PhD,
- Theresa Cole, MD, PhD,
- Brian Eley, MD,
- Nahla H.H. Erwa, DipRCPATH,
- Sara Espinosa-Padilla, PhD,
- Emilia Faria, MD,
- Nelson A. Rosario Filho, MD, PhD,
- Ramsay Fuleihan, MD,
- Nermeen Galal, MD, PhD,
- Elizabeth Garabedian, RN, MSLS,
- Mary Hintermeyer, BN,
- Kohsuke Imai, MD, PhD,
- Carla Irani, MD, MSCE,
- Ebtihal Kamal, MD,
- Nadia Kechout, MD, PhD,
- Adam Klocperk, MD, PhD,
- Michael Levin, MD, PhD,
- Tomas Milota, MD, PhD,
- Monia Ouederni, MD,
- Roberto Paganelli, MD,
- Claudio Pignata, MD, PhD,
- Farah N. Qamar, MBBS, FCPS, MSc, DHPE, FRCP,
- Isabella Quinti, MD, PhD,
- Sonia Qureshi, MBBS, FCPS, MSc,
- Nita Radhakrishnan, MD, PhD,
- Nima Rezaei, MD, PhD,
- John Routes, MD, PhD,
- Surjit Singh, MD, DCH (Lon.), FRCP (Lon.), FRCPCH (Lon.), FAMS,
- Sangeetha Siniah, MBBS, MRCPCH,
- Intisar Abdel-Hakam Taha, MD, SMSB,
- Luciana K. Tanno, MD, Ph.D,
- Ben Van Dort, BN,
- Alla Volokha, MD, PhD, DSc,
- Kathleen Sullivan, MD, PhD
Affiliations
- Zeinab A. El-Sayed, MD, PhD
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt; Corresponding author. Madinaty, V 202, G 12, Cairo, 19519, Egypt.
- Dalia H. El-Ghoneimy, MD, PhD
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
- José A. Ortega-Martell, MD
- Clínica de Alergia Pediátrica- Mexico
- Nesrine Radwan, MD, PhD
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
- Juan C. Aldave, MD
- Allergy and Clinical Immunology, Hospital Nacional Edgardo Rebagliati Martins, Peru
- Waleed Al-Herz, MD
- Allergy and Clinical Immunology Unit, Pediatric Department, AlSabah Hospital, Faculty of Medicine, Kuwait University, Kuwait
- Maryam A. Al-Nesf, MD, ABHS
- Department of Pediatrics, Pulmonary Division- Allergy and Immunology Section, Qatar
- Antonio Condino-Neto, MD, PhD
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Theresa Cole, MD, PhD
- Department of Allergy and Immunology- Royal Children's Hospital, Australia
- Brian Eley, MD
- Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, South Africa
- Nahla H.H. Erwa, DipRCPATH
- Allergy and Immunology Unit- Soba University Hospital and Faculty of Medicine, University of Khartoum, Sudan
- Sara Espinosa-Padilla, PhD
- Instituto Nacional de Pediatría, Immunodeficiencies Laboratory, Mexico
- Emilia Faria, MD
- Immunoallergy Department, Coimbra Hospital and University Centre (CHUC), Portugal
- Nelson A. Rosario Filho, MD, PhD
- Department of Pediatrics, Federal University of Parana, Brazil
- Ramsay Fuleihan, MD
- Pediatric Allergy, Immunology and Rheumatology, Columbia University Medical Center, New York, USA
- Nermeen Galal, MD, PhD
- Department of Pediatrics- Division of Immunology, Cairo University, Egypt
- Elizabeth Garabedian, RN, MSLS
- National Human Genome Research Institute, National Institute of Health, USA
- Mary Hintermeyer, BN
- Department of Allergy and Clinical Immunology- Children's Hospital of Wisconsin, Medical College of Wisconsin, USA
- Kohsuke Imai, MD, PhD
- Department of Pediatrics-Tokyo Medical and Dental University, Japan
- Carla Irani, MD, MSCE
- Department of Internal Medicine and Clinical Immunology, Hotel Dieu de France Hospital, Beirut, Lebanon
- Ebtihal Kamal, MD
- Allergy and Immunology Unit- Soba University Hospital and Faculty of Medicine, University of Khartoum, Sudan
- Nadia Kechout, MD, PhD
- Department of Immunology, Pasteur Institute of Algeria, Algeria
- Adam Klocperk, MD, PhD
- Department of Immunology, University Hospital Motol and the 2nd Faculty of Medicine, Charles University, Czech Republic
- Michael Levin, MD, PhD
- Division of Pediatric Allergy, University of Cape Town, South Africa
- Tomas Milota, MD, PhD
- Department of Immunology, University Hospital Motol and the 2nd Faculty of Medicine, Charles University, Czech Republic
- Monia Ouederni, MD
- Department of Pediatrics, Immuno-hematology and Stem Cell Transplantation- Bone Marrow Transplantation Center Tunisia
- Roberto Paganelli, MD
- Department of Medicine and Sciences of Aging, University “G. D’Annunzio”, Chieti-Pescara – and YDA, Institute of Clinical Immunotherapy and Advanced Biological Treatments, Pescara, Italy
- Claudio Pignata, MD, PhD
- Translational Medical Sciences-Pediatric Immunology, Italy
- Farah N. Qamar, MBBS, FCPS, MSc, DHPE, FRCP
- Department of Pediatrics and Child Health- Aga Khan University Hospital, Karachi, Pakistan
- Isabella Quinti, MD, PhD
- Department of Molecular Medicine, PID Reference Centre, Sapienza University of Rome, Italy
- Sonia Qureshi, MBBS, FCPS, MSc
- Department of Pediatrics and Child Health- Aga Khan University Hospital, Karachi, Pakistan
- Nita Radhakrishnan, MD, PhD
- Department of Pediatric Hematology Oncology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute Noida, Delhi NCR 201303, India
- Nima Rezaei, MD, PhD
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- John Routes, MD, PhD
- Department of Allergy and Clinical Immunology- Children's Hospital of Wisconsin, Medical College of Wisconsin, USA
- Surjit Singh, MD, DCH (Lon.), FRCP (Lon.), FRCPCH (Lon.), FAMS
- Department of Pediatrics and Chief, Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- Sangeetha Siniah, MBBS, MRCPCH
- Hospital Tunku Azizah, Women and Children Hospital Kuala Lumpur, Malaysia
- Intisar Abdel-Hakam Taha, MD, SMSB
- Gaafer Ibn Ouf Specialist Paediatric Hospital, Sudan
- Luciana K. Tanno, MD, Ph.D
- Department of Pulmonology, Division of Allergy, University Hospital of Montpellier, Montpellier, France; Desbrest Institute of Epidemiology and Public Health, UMR UA11, INSERM, University of Montpellier, Montpellier, France; WHO Collaborating Centre on Classification Scientific Support, Montpellier, France
- Ben Van Dort, BN
- Department of Allergy and Immunology- Royal Children's Hospital, Australia
- Alla Volokha, MD, PhD, DSc
- Department of Pediatric Infectious Diseases and Immunology- Shupyk National Medical Academy of Postgraduate Education, Ukraine
- Kathleen Sullivan, MD, PhD
- Department of Pediatrics, Children's Hospital of Philadelphia, USA
- Journal volume & issue
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Vol. 15,
no. 6
p. 100657
Abstract
Background: Allergies have long been observed in Inborn Errors of Immunity (IEI) and might even be the first presentation resulting in delayed diagnosis or misdiagnosis in some cases. However, data on the prevalence of allergic diseases among IEI patients are limited and contradictory. Objective: To provide a worldwide view of allergic diseases, across a broad spectrum of IEI, and their impact on the timely diagnosis of IEI. Methods: This is a worldwide study, conceived by the World Allergy Organization (WAO) Inborn Errors of Immunity Committee. A questionnaire was developed and pilot-tested and was sent via email to collect data from 61 immunology centers known to treat pediatric and/or adult IEI patients in 41 countries. In addition, a query was submitted to The United States Immunodeficiency Network (USIDNET) at its website. Results: Thirty centers in 23 countries caring for a total of 8450 IEI patients responded. The USIDNET dataset included 2332 patients. Data from responders showed that a median (IQR) of 16.3% (10–28.8%) of patients experienced allergic diseases during the course of their IEI as follows: 3.6% (1.3–11.3%) had bronchial asthma, 3.6% (1.9–9.1%) atopic dermatitis, 3.0% (1.0–7.8%) allergic rhinitis, and 1.3% (0.5–3.3%) food allergy. As per the USIDNET data, the frequency of allergy among IEI patients was 68.8% (bronchial asthma in 46.9%). The percentage of IEI patients who presented initially with allergic disorders was 8% (5–25%) and diagnosis delay was reported in 7.5% (0.9–20.6%). Predominantly antibody deficiencies had the highest frequency of allergic disease followed by combined immunodeficiency with a frequency of 40.3% (19.2–62.5%) and 20.0% (10–32%) respectively. As per the data of centers, anaphylaxis occurred in 25/8450 patients (0.3%) whereas per USIDNET dataset, it occurred in 249/2332 (10.6%); drugs and food allergy were the main causes in both datasets. Conclusions: This multinational study brings to focus the relation between allergic diseases and IEI. Major allergies do occur in IEI patients but were less frequent than the general population. Initial presentation with allergy could adversely affect the timely diagnosis of IEI. There is a need for policies to raise awareness and educate primary care and other referring specialties on the association of allergic diseases with IEI. This study provides a network among centers for future prospective studies in the field.
