CASE REPORT
The significance of medical history and its impact on the early diagnosis of inborn errors of immunity
More details
Hide details
1
Department of Paediatrics, Haematology, and Oncology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
These authors had equal contribution to this work
Submission date: 2023-12-28
Final revision date: 2024-02-10
Acceptance date: 2024-02-11
Publication date: 2024-09-20
Corresponding author
Elżbieta Grześk
Department of Paediatrics, Haematology, and Oncology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Marii-Skłodowskiej Curie 9, 85-094 Bydgoszcz, Poland
Pediatr Pol 2024;99(3):246-249
KEYWORDS
TOPICS
ABSTRACT
Inborn errors of immunity (IEI) are genetically determined disorders which present clinically as increased susceptibility to infectious, autoinflammatory, or autoimmune diseases, potentially leading to fatal outcomes. Some doctors omit collecting family history, an element of the examination that allows for initial risk stratification of the disease and permits further detailed diagnostics. Currently, unfortunately, the role of medical history is downplayed by primary care physicians in favour of diagnostic tests. The availability of genetic tests in most countries is low, so we would like to use examples to emphasise the enormity of the role of anamnesis, the simplest part of the patient’s examination.
The medical history provided valuable information that raised suspicions of IEI. Consequently, genetic studies were conducted for meticulous diagnoses, and then the most effective treatments were administered, including pre-emptive haematopoietic stem cell transplantation.
REFERENCES (10)
1.
Abraham RS. How to evaluate for immunodeficiency in patients with autoimmune cytopenias: laboratory evaluation for the diagnosis of inborn errors of immunity associated with immune dysregulation. Hematology Am Soc Hematol Educ Program 2020; 2020: 661-672.
2.
Cooper MA, Zimmerman O, Nataraj R, et al. Lifelong immune modulation versus hematopoietic cell therapy for inborn errors of immunity. J Allergy Clin Immunol Pract 2021; 9: 628-639.
3.
Dąbrowska A, Grześk E, Urbańczyk A, et al. Extended list of warning signs in qualification to diagnosis and treatment of inborn errors of immunity in children and young adults. J Clin Med 2023; 12: 3401.
4.
Demir DD, Asnaashari K, Rezaei N, et al. Management of inborn errors of immunity in the genomic era. Turk Arch Pediatr 2022; 57: 132-145.
5.
Nakano Y, Rabinowicz R, Malkin D. Genetic predisposition to cancers in children and adolescents. Curr Opin Pediatr 2023; 35: 55-62.
6.
Giżewska M, Durda K, Winter T, et al. Newborn screening for SCID and other severe primary immunodeficiency in the Polish–German transborder area: experience from the first 14 months of collaboration. Front Immunol 2020; 11: 1948.
7.
Grześk E, Kołtan S, Dąbrowska A, et al. Case report: cellular therapy for hydroa vacciniforme-like lymphoproliferative disorder in pediatric common variable immunodeficiency with chronic active Epstein-Barr virus infection. Front Immunol 2022; 13: 915986.
8.
Lankester AC, Neven B, Mahlaoui N, et al. Hematopoietic cell transplantation in severe combined immunodeficiency: the SCETIDE 2006–2014 European cohort. J Allergy Clin Immunol 2022; 149: 1744-1754.e8.
9.
Reilly L, Emonts M. Recurrent or unusual infections in children – when to worry about inborn errors of immunity. Ther Adv Infect Dis 2023; 10: 20499361231162978.
10.
Slatter M, Lum SH. Personalized hematopoietic stem cell transplantation for inborn errors of immunity. Front Immunol 2023; 14: 1162605.