Abstract:
OBJECTIVES:Gastrointestinal manifestations are frequent in patients with common variable immunodeficiency (CVID), and some of the patients present with celiac-like features. Diagnosing celiac disease (CD) in CVID however is challenging, as autoantibody detection and histopathology of the small intestine cannot reliably discriminate between classic CD and a celiac-like disease in these individuals. For the development of classic gluten-sensitive CD a certain HLA haplotype involving the loci DQA1* and DQB1* and encoding two different HLA DQ heterodimers is the prerequisite. We aimed to determine the frequency of these haplotypes in CVID patients with suspected CD. Furthermore, we report on autoimmune manifestations and the lymphocyte phenotype in these patients. METHODS:By retrospective analysis data on gastrointestinal symptoms, diet, concurrent autoimmune diseases, and routine laboratory values were collected. CVID patients were classified according to their B-cell phenotype. Expression of HLA-DQA1* and HLA-DQB1* alleles were determined by genetic analysis. RESULTS:Twenty out of 250 CVID patients presented with a clinical phenotype resembling celiac disease. Four (20%) out of these CVID patients carried the CD-associated HLA DQ2.5 or DQ8 heterodimer, while HLA DQ2.5 was present in 100% of a CD control cohort. Gluten-free diet (GFD) resulted in a clinical and histological response in two out of four patients with HLA high-risk alleles for CD. The response could not be assessed in the remaining two patients, as these patients did not adhere sufficiently long to GFD. The percentage of autoimmune manifestations other than CD was high (50%) in CVID patients presenting with a CD-like enteropathy, and most of these patients had an expansion of B-cells with low expression of CD21 (CD21low B-cells). CONCLUSIONS:In CVID patients with suspected celiac disease typing of the HLA loci DQA1 and DQB1 can help to identify those that have a genetic susceptibility for CD. In CVID patients with a celiac-like phenotype but negative for CD-associated HLA-DQ markers, an autoimmune enteropathy (AIE) as part of an extended autoimmune dysregulation needs to be considered. This has important implications for further diagnostics and therapy of these patients.
journal_name
J Clin Immunoljournal_title
Journal of clinical immunologyauthors
Venhoff N,Emmerich F,Neagu M,Salzer U,Koehn C,Driever S,Kreisel W,Rizzi M,Effelsberg NM,Kollert F,Goldacker S,Voll RE,Warnatz K,Thiel Jdoi
10.1007/s10875-013-9892-3subject
Has Abstractpub_date
2013-07-01 00:00:00pages
909-16issue
5eissn
0271-9142issn
1573-2592journal_volume
33pub_type
杂志文章abstract::Thymomas can present with a variety of paraneoplastic manifestations, mostly of autoimmune origin, including Good's syndrome when there is associated hypogammaglobulinemia. Although pure red cell aplasia is a recognised complication of thymoma, selective white cell aplasia is very rare, particularly in Good's syndrome...
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journal_title:Journal of clinical immunology
pub_type: 杂志文章,多中心研究
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abstract::The concentrations of seven immunoglobulin isotypes (IgA, IgE, IgM, IgG1, IgG2, IgG3, and IgG4) were measured in the sera of 207 Finnish blood donors, and they were allotyped with anti-Gm antibodies: anti-f, anti-a, anti-x, and anti-n. The above population could be divided into 12 phenotypes, and significant differenc...
journal_title:Journal of clinical immunology
pub_type: 杂志文章
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
doi:10.1007/s10875-014-0037-0
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
doi:10.1007/s10875-011-9517-7
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
doi:10.1007/BF00920243
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
doi:10.1007/s10875-013-9952-8
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journal_title:Journal of clinical immunology
pub_type: 临床试验,杂志文章,多中心研究
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abstract::Immunoglobulin isolated from sera of homosexual men infected with human immunodeficiency virus (HIV) inhibited the reverse transcriptase (RT) activity of HIV. The inhibitory activity was specifically directed against HIV RT, and not against other mammalian retrovirus RT, including human T-lymphotropic virus type I. Th...
journal_title:Journal of clinical immunology
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
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journal_title:Journal of clinical immunology
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
doi:10.1007/s10875-019-00604-9
更新日期:2019-02-01 00:00:00
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journal_title:Journal of clinical immunology
pub_type: 杂志文章,评审
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journal_title:Journal of clinical immunology
pub_type: 杂志文章,收录出版
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更新日期:2006-07-01 00:00:00
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journal_title:Journal of clinical immunology
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更新日期:2019-07-01 00:00:00
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:Journal of clinical immunology
pub_type: 杂志文章
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journal_title:Journal of clinical immunology
pub_type: 杂志文章,评审
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更新日期:2007-05-01 00:00:00