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Article: Inborn Errors of Immunity-the Sri Lankan Experience 2010-2022

TitleInborn Errors of Immunity-the Sri Lankan Experience 2010-2022
Authors
KeywordsChronic granulomatous disease
IEI in Sri Lanka
Inborn errors of immunity
Next generation sequencing
Severe combined immune deficiency
Issue Date22-Jul-2023
PublisherSpringer
Citation
Journal of Clinical Immunology, 2023, v. 13 How to Cite?
Abstract

Purpose

Inborn errors of immunity (IEI) are typically monogenic. Data from the Indian subcontinent are relatively scarce. This paper evaluates IEI diagnosed in Sri Lanka.

Methods

Data of patients diagnosed with IEI from 2010 to 2022 at the Department of Immunology, Medical Research Institute, Colombo, Sri Lanka, were retrospectively analyzed.

Results

Two hundred and six patients were diagnosed with IEI, with a prevalence of 0.94 per 100,000. The onset of disease was below 12 years in 84.9%, whereas in 10.9%, it was after 18 years. The male: female ratio was 1.78:1. Consanguinity was identified in 26.6%. IEI were found in all but one (bone marrow failure) of the 10 IUIS categories. Predominantly antibody deficiencies were the most common category among the nine identified (30.1%), followed by combined immune deficiencies with syndromic features (21.3%), immunodeficiencies affecting cellular and humoral immunity (19.9%), congenital defects of phagocyte number or function (13.1%), and defects in intrinsic and innate immunity (8.2%). Severe combined immune deficiency (SCID) was the commonest disease (14.6%), followed by chronic granulomatous disease (CGD) (10.6%) and X linked agammaglobulinemia (8.7%). Of the patients with a known outcome (n = 184), 51 died (27.7%). Mortality rates were high in SCID (83.3%), Omenn syndrome (OS) (100%), and CGD (31.8%) patients.

Conclusion

IEI in Sri Lanka are diagnosed mainly in childhood. The low diagnosis rates suggest a need for educating clinicians regarding IEI in adulthood. The high mortality rates associated with some IEI indicate the need of transplant services in the country.


Persistent Identifierhttp://hdl.handle.net/10722/331429
ISSN
2023 Impact Factor: 7.2
2023 SCImago Journal Rankings: 2.258
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorDasanayake, D-
dc.contributor.authorBustamante, J-
dc.contributor.authorBoisson-Dupuis, S-
dc.contributor.authorKarunatilleke, C-
dc.contributor.authorThambyrajah, J-
dc.contributor.authorPuel, A-
dc.contributor.authorChan, KW-
dc.contributor.authorDoffinger, R-
dc.contributor.authorLau, YL-
dc.contributor.authorCasanova, JL-
dc.contributor.authorKumararatne, D-
dc.contributor.authorde Silva, R-
dc.date.accessioned2023-09-21T06:55:38Z-
dc.date.available2023-09-21T06:55:38Z-
dc.date.issued2023-07-22-
dc.identifier.citationJournal of Clinical Immunology, 2023, v. 13-
dc.identifier.issn0271-9142-
dc.identifier.urihttp://hdl.handle.net/10722/331429-
dc.description.abstract<h3>Purpose</h3><p>Inborn errors of immunity (IEI) are typically monogenic. Data from the Indian subcontinent are relatively scarce. This paper evaluates IEI diagnosed in Sri Lanka.</p><h3>Methods</h3><p>Data of patients diagnosed with IEI from 2010 to 2022 at the Department of Immunology, Medical Research Institute, Colombo, Sri Lanka, were retrospectively analyzed.</p><h3>Results</h3><p>Two hundred and six patients were diagnosed with IEI, with a prevalence of 0.94 per 100,000. The onset of disease was below 12 years in 84.9%, whereas in 10.9%, it was after 18 years. The male: female ratio was 1.78:1. Consanguinity was identified in 26.6%. IEI were found in all but one (bone marrow failure) of the 10 IUIS categories. Predominantly antibody deficiencies were the most common category among the nine identified (30.1%), followed by combined immune deficiencies with syndromic features (21.3%), immunodeficiencies affecting cellular and humoral immunity (19.9%), congenital defects of phagocyte number or function (13.1%), and defects in intrinsic and innate immunity (8.2%). Severe combined immune deficiency (SCID) was the commonest disease (14.6%), followed by chronic granulomatous disease (CGD) (10.6%) and X linked agammaglobulinemia (8.7%). Of the patients with a known outcome (<em>n</em> = 184), 51 died (27.7%). Mortality rates were high in SCID (83.3%), Omenn syndrome (OS) (100%), and CGD (31.8%) patients.</p><h3>Conclusion</h3><p>IEI in Sri Lanka are diagnosed mainly in childhood. The low diagnosis rates suggest a need for educating clinicians regarding IEI in adulthood. The high mortality rates associated with some IEI indicate the need of transplant services in the country.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofJournal of Clinical Immunology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectChronic granulomatous disease-
dc.subjectIEI in Sri Lanka-
dc.subjectInborn errors of immunity-
dc.subjectNext generation sequencing-
dc.subjectSevere combined immune deficiency-
dc.titleInborn Errors of Immunity-the Sri Lankan Experience 2010-2022-
dc.typeArticle-
dc.identifier.doi10.1007/s10875-023-01542-3-
dc.identifier.scopuseid_2-s2.0-85165606601-
dc.identifier.volume13-
dc.identifier.eissn1573-2592-
dc.identifier.isiWOS:001035139700002-
dc.identifier.issnl0271-9142-

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