Keywords
Allergic diseases
Sensitization
Hypersensitivity reactions
How to Cite
Abstract
Objective: To describe the clinical characteristics of allergic diseases (AD) as comorbidities—distinct from primary atopic diseases (PAD)—in pediatric patients diagnosed with IEI.
Methods: An observational and retrospective study was made. We included pediatric population diagnosed with IEI and allergic comorbidity between 2013-2023. The diagnosis was done considering the criteria from the ESID and IUIS-2022. We performed a descriptive analysis of the variables (frequencies/percentages). For qualitative variables, we used OR to obtain the probability of occurrence of allergic sensitization among patients with AD and IEI. Every analysis was performed with the software R Studio version 3.2.2.
Results: There were 366 patients with diagnosis of IEI, 238 had concomitant AD. 59.6% were males. Mean age was 5 years. 84% had antibody-specific deficiencies, 8% combined immunodeficiencies associated to well-defined syndromes, 2.9% congenital defects in phagocytes, 2.5% combined-immunodeficiencies, 1.7% autoinflammatory diseases, and 0.8% defects in intrinsic and innate immunity. The distribution of the ADs was asthma 48.7%, rhinitis 18.9%, atopic-dermatitis 15.1%, food-allergy 8.4%, acute urticaria 5%, and chronic urticaria 3.8%.
Conclusion: Allergic diseases are increasingly recognized as key indicators for early IEI diagnosis. These conditions may coexist without representing PAD, emphasizing the need for comprehensive care. Recognizing this heterogeneity supports a multidisciplinary approach to improve early detection and management of IEI.
Keywords: Inborn errors of immunity; Allergic diseases; Sensitization; Hypersensitivity reactions.
References
1. Tangye SG, Al-Herz W, Aziz Bousfiha ·, Cunningham-Rundles C, Jose ·, Franco L, et al. Human Inborn Errors of Immunity: 2022 Update on the Classification from the International Union of Immunological Societies Expert Committee. https://doi.org/10.1007/s10875-022-01289-3
2. Raje N, Dinakar C. Overview of Immunodeficiency Disorders. Immunol Allergy Clin North Am [Internet]. 2015; 35 (4): 599. /pmc/articles/PMC4600970/
3. Amaya-Uribe L, Rojas M, Azizi G, Anaya JM, Gershwin ME. Primary immunodeficiency and autoimmunity: A comprehensive review. J Autoimmun. 2019; 99: 52-72. https://pubmed.ncbi.nlm.nih.gov/30795880/
4. Chapel H, Prevot J, Gaspar HB, Español T, Bonilla FA, Solis L, et al. Primary immune deficiencies - principles of care. Front Immunol. 2014; 5 (DEC). https://pubmed.ncbi.nlm.nih.gov/25566243/
5. Inborn errors of immunity (primary immunodeficiencies): Classification. 2024. https://medilib.ir/uptodate/show/117758
6. Leonardi L, Rivalta B, Cancrini C, Chiappini E, et al. Update in Primary Immunodeficiencies. Acta Biomed. 2020; 91 (11-S): 1-6. https://pubmed.ncbi.nlm.nih.gov/33004780/
7. Chan SK, Gelfand EW. Primary Immunodeficiency Masquerading as Allergic Disease. Immunol Allergy Clin North Am 2015; 35 (4): 767-78. https://pubmed.ncbi.nlm.nih.gov/26454318/
8. ESID - European Society for Immunodeficiencies. 2024. https://esid.org/
9. Castagnoli R, Lougaris V, Giardino G, Volpi S, et al. Inborn errors of immunity with atopic phenotypes: A practical guide for allergists. World Allergy Organ J. 2021; 14 (2). https://pubmed.ncbi.nlm.nih.gov/33717395/
10. Bousfiha A, Moundir A, Tangye SG, Picard C, et al. The 2022 Update of IUIS Phenotypical Classification for Human Inborn Errors of Immunity. J Clin Immunol 2022; 42 (7): 1508-20. https://pubmed.ncbi.nlm.nih.gov/36198931/
11. Thalhammer J, Kindle G, Nieters A, Rusch S, et al. Initial presenting manifestations in 16,486 patients with inborn errors of immunity include infections and noninfectious manifestations. J Allergy Clin Immunol 2021; 148 (5): 1332-1341.e5. https://pubmed.ncbi.nlm.nih.gov/33895260/
12. Smith KL, Dai D, Modi BP, Sara R, et al. Inborn Errors of Immunity Associated With Type 2 Inflammation in the USIDNET Registry. Front Immunol 2022; 13. https://pubmed.ncbi.nlm.nih.gov/35273610/
13. Ogershok PR, Hogan MB, Welch JE, Corder WT, et al. Spectrum of illness in pediatric common variable immunodeficiency. Ann Allergy Asthma Immunol 2006; 97 (5): 653-6. https://pubmed.ncbi.nlm.nih.gov/17165275/
14. El-Sayed ZA, El-Ghoneimy DH, Ortega-Martell JA, Radwan N, et al. Allergic manifestations of inborn errors of immunity and their impact on the diagnosis: A worldwide study. World Allergy Org J 2022; 15 (6): 100657.
15. Edwards E, Razvi S, Cunningham-Rundles C. IgA deficiency: Clinical correlates and responses to pneumococcal vaccine. Clinical Immunology 2004; 111 (1): 93-7. https://pubmed.ncbi.nlm.nih.gov/15093556/
16. Chin A, Balasubramanyam S, Davis CM. Very Elevated IgE, Atopy, and Severe Infection: A Genomics-Based Diagnostic Approach to a Spectrum of Diseases. Case Reports Immunol 2021; 2021.
17. Vaseghi-Shanjani M, Smith KL, Sara RJ, Modi BP, et al. Inborn errors of immunity manifesting as atopic disorders. J Allergy Clin Immunol 2021; 148 (5): 1130-9. https://pubmed.ncbi.nlm.nih.gov/34428518/
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2025 Revista Alergia México