Review Article
Association of Primary Minor Immunodeficiencies and Autoimmune Syndromes in Humans: Current Status, Existing Problems and Prospects for Further Research


This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The authors shall retain the copyright of their work but allow the Publisher to publish, copy, distribute, and convey the work.
License
Trends in Immunotherapy (TI) publishes accepted manuscripts under Creative Commons Attribution 4.0 International (CC BY 4.0). Authors who submit their papers for publication by TI agree to have the CC BY 4.0 license applied to their work, and that anyone is allowed to reuse the article or part of it free of charge for any purpose, including commercial use. As long as the author and original source are properly cited, anyone may copy, redistribute, reuse, and transform the content.
Received: 16 December 2025; Revised: 27 January 2026; Accepted: 26 March 2026; Published: 7 May 2026
Autoimmune manifestations of primary minor immunodeficiencies (PMDs)—highly prevalent conditions that may represent a population-level model of autoimmunity—have not been systematically analyzed. The study aims to evaluate the current evidence for associations between PMDs and autoimmune syndromes. A systematic search of PubMed (MEDLINE) for 1980–2025 was conducted using keywords related to PMDs and autoimmune syndromes. The search was performed in two stages: an initial broad screening and a subsequent refined search with specific disease-related terms. High-quality peer-reviewed studies most relevant to the study objectives were selected. Available evidence indicates that PMDs commonly manifest through autoimmune syndromes according to a principle of universality, with important geographic, ethnic, age-related, sex-related, and ontogenetic variation. The strength of PMD–autoimmunity associations varies widely, reflecting major heterogeneity in both disease mechanisms and study quality. Key factors influencing clinical and epidemiological findings include terminological inconsistencies, multiple autoimmune pathways, heterogeneity of PMD origin and evolution, overlap with other immunodeficiencies and comorbidities, variability of clinical phenotypes, difficulties distinguishing PMDs from secondary immunosuppression, and the absence of standardized diagnostic criteria for many PMDs. Elementary models of autoimmune induction in immunocompromised individuals are proposed, together with a framework for personalized assessment of autoimmune disease in the context of PMDs, and implications for rational immunotherapy are discussed. PMDs are associated with diverse autoimmune syndromes and likely represent a major etiological factor of human autoimmunity at the population level. However, this data should be validated in further studies.
Keywords:
Primary Immunodeficiency Immune Dysregulation Autoimmune Disease SusceptibilityReferences
- Amaya-Uribe, L.; Rojas, M.; Azizi, G.; et al. Primary immunodeficiency and autoimmunity: A comprehensive review. J. Autoimmun. 2019, 99, 52–72.
- Li, P.; Wang, Q.; Yang, Y.; et al. Autoimmune thyroid disease and human health: A systematic review of Mendelian randomization studies. Front. Immunol. 2025, 16, 1689498.
- Masoch, F.; Durieu, I.; Roubertou, Y.; et al. Primary humoral immunodeficiencies associated with enteropathies: An update. Rev. Med. Interne 2026, in press. DOI: https://doi.org/10.1016/j.revmed.2026.02.005 (in French)
- Goudouris, E.S. Immunodeficiencies: non-infectious manifestations. J. Pediatr. 2021, 97, S24–S33.
- Khanbabaee, G.; Pourghasem, M.; Jamee, M.; et al. Demographic, clinical, and immunological features in combined immunodeficiency patients: a comparative analysis of those with and without pulmonary manifestations - a multicenter study from Iran. BMC Pulm. Med. 2026, 26, 100.
- Çelik, G.G.; Taş, D.A.; Tahiroglu, A.Y.; et al. Mannose-Binding Lectin 2 Gene Polymorphism in PANDAS Patients. Noro Psikiyatr Ars. 2018, 56, 99–105.
- Amador, W.F.O.; Vitor, I.C.; Tomé, M.R.; et al. Global epidemiology and determinants of autoimmune hepatitis recurrence post-liver transplantation: A systematic review and meta-analysis. Transplant. Rev. 2026, 40, 100984.
- Di Cosmo, L.; Mulic-Al Bunni, S.; Goh, Y.; et al. Systematic Review and Meta-Analysis of the Clinical Features Associated With Seronegative Autoimmune Encephalitis. Neurol. Neuroimmunol. Neuroinflamm. 2026, 13, e200540.
- Alhumaid, S.; Al Mutared, K.M.; Al Alawi, Z.; et al. Severity of SARS-CoV-2 infection in children with inborn errors of immunity (primary immunodeficiencies): a systematic review. Allergy Asthma Clin. Immunol. 2023, 19, 69.
- Tzang, C.C.; Sheng, H.; Kuo, V.F.; et al. Association between COVID-19 and New-Onset Autoimmune Diseases: Updated Systematic Review and Meta-Analysis of 97 Million Individuals. Clin. Rev. Allergy Immunol. 2025, 68, 111.
- Moundir, A.; Jeddane, L.; Bousfiha, A.A. Insights into the genetic theory of infectious diseases. Tunis Med. 2024, 102, 521–528.
- Woessner, N.M.; Keller, B.; Minguet, S. LCK at the crossroad of immunodeficiency and autoimmunity: Mechanisms and therapeutic opportunities. Immunol. Lett. 2026, 279, 107126.
- Cortesi, M.; Soresina, A.; Dotta, L.; et al. Pathogenesis of Autoimmune Cytopenias in Inborn Errors of Immunity Revealing Novel Therapeutic Targets. Front. Immunol. 2022, 13, 846660.
- Tsoulis, M.W.; Williams, K.W. Keeping up with recent developments in immunodeficiency. Ann. Allergy Asthma Immunol. 2025, 134, 259–268.
- Kose, H.; Akalin, A. Clinical and genetic spectrum of inborn errors of immunity: a retrospective study on outcomes at a single center. Front. Immunol. 2026, 17, 1758410.
- Lee, P.Y.; Abraham, R.S. The complex relationship between inborn errors of immunity and autoimmunity. J. Allergy Clin. Immunol. 2026, 157, 337–339.
- Bousfiha, A.; Moundir, A.; Tangye, S.G.; et al. The 2022 Update of IUIS Phenotypical Classification for Human Inborn Errors of Immunity. J. Clin. Immunol. 2022, 42, 1508–1520.
- Tangye, S.G.; Al-Herz, W.; Bousfiha, A.; et al. Human Inborn Errors of Immunity: 2022 Update on the Classification from the International Union of Immunological Societies Expert Committee. J. Clin. Immunol. 2022, 42, 1473–1507.
- Fumagalli, R.; Saettini, F. Expanding the Spectrum of Selective IgM Deficiency: From Infections to Immune Dysregulation. Int. J. Mol. Sci. 2025, 26, 9003.
- Collet, A.; Coiffard, B.; Ledoult, E.; et al. IgA and IgM-enriched Immunoglobulins in Primary Immunodeficiencies: a Pilot Study. J. Clin. Immunol. 2025, 46, 2.
- Xu, J.; Chen, G.; Yan, Z.; et al. Effect of mannose-binding lectin gene polymorphisms on the risk of rheumatoid arthritis: Evidence from a meta-analysis. Int. J. Rheum. Dis. 2021, 24, 300–313.
- Vosughimotlagh, A.; Rasouli, S.E.; Rafiemanesh, H.; et al. Clinical manifestation for immunoglobulin A deficiency: a systematic review and meta-analysis. Allergy Asthma Clin. Immunol. 2023, 19, 75.
- Aluri, J.; Cooper, M.A. Somatic mosaicism in inborn errors of immunity: Current knowledge, challenges, and future perspectives. Semin. Immunol. 2023, 67, 101761.
- Zhang, W.; Scott, A.F.; Mohr, D.W.; et al. Complete CD16A Deficiency and Defective NK Cell Function in a Man Living with HIV. J. Clin. Immunol. 2025, 45, 98.
- Lamas, A.; Faria, R.; Marinho, A.; et al. The mosaic of systemic lupus erythematosus: From autoimmunity to autoinflammation and immunodeficiency and back. Autoimmun. Rev. 2024, 23, 103675.
- Dupré, L.; Castanon, I.; Boztug, K. Immune-related actinopathies at the cross-road of immunodeficiency, autoimmunity and autoinflammation. Nat. Rev. Immunol. 2026, 26, 89–111.
- Torres-Salido, M.; Cortés-Hernández, J.; Balada, E.; et al. Systemic lupus erythematosus as a first presentation of common variable immunodeficiency associated with infrequent mannose-binding lectin gene polymorphisms. Rheumatol. Int. 2011, 31, 537–541.
- Vemula, M.; Oftedal, B.E.; Iraji, D.; et al. A novel heterozygous pathogenic AIRE variant causing autoimmunity but not infectious susceptibility. J. Hum. Immun. 2025, 1, e20250151.
- Uğraklı, S.; Çölkesen, F.; Tatar, S.; et al. Association between gut microbiota-derived TMAO, systemic inflammatory markers, and echocardiographic findings in patients with common variable immunodeficiency. BMC Immunol. 2026, 27, 18.
- Sacco, K.A.; Notarangelo, L.D.; Delmonte, O.M. When to suspect inborn errors of immunity in Epstein-Barr virus-related lymphoproliferative disorders. Clin. Microbiol. Infect. 2023, 29, 457–462.
- Lumsden, J.M.; Urv, T.K. The Rare Diseases Clinical Research Network: a model for clinical trial readiness. Ther. Adv. Rare Dis. 2023, 4, 1–18.
- Lnu, P.; Sehgal, V.; Kapila, S.; et al. Ataxia Telangiectasia Presenting as Cervical Dystonia. Cureus 2022, 14, e30723.
- Gross, S.; Blaiss, M.S.; Herrod, H.G. Role of immunoglobulin subclasses and specific antibody determinations in the evaluation of recurrent infection in children. J. Pediatr. 1992, 121, 516–522.
- Azizoglu, Z.B.; Babayeva, R.; Haskologlu, Z.S.; et al. DIAPH1-Deficiency is Associated with Major T, NK and ILC Defects in Humans. J. Clin. Immunol. 2024, 44, 175.
- Litzman, J.; Ward, A.M.; Wild, G.; et al. Serum IgD levels in children under investigation for and with defined immunodeficiency. Int Arch Allergy Immunol. 1997, 114, 54–58. DOI: https://doi.org/10.1159/000237643
- Vivarelli, E.; Matucci, A.; Bormioli, S.; et al. Effectiveness of low-dose intravenous immunoglobulin therapy in minor primary antibody deficiencies: A 2-year real-life experience. Clin. Exp. Immunol. 2021, 205, 346–353.
- Van Kessel, D.A.; Horikx, P.E.; Van Houte, A.J.; et al. Clinical and immunological evaluation of patients with mild IgG1 deficiency. Clin. Exp. Immunol. 1999, 118, 102–107.
- Janssen, L.M.A.; Bassett, P.; Macken, T.; et al. Mild Hypogammaglobulinemia Can Be a Serious Condition. Front. Immunol. 2018, 9, 2384.
- Smits, B.M.; Kleine Budde, I.; de Vries, E.; et al. Immunoglobulin Replacement Therapy Versus Antibiotic Prophylaxis as Treatment for Incomplete Primary Antibody Deficiency. J. Clin. Immunol. 2021, 41, 382–392.
- Aghamohammadi, A.; Mohammadi, J.; Parvaneh, N.; et al. Progression of selective IgA deficiency to common variable immunodeficiency. Int. Arch. Allergy Immunol. 2008, 147, 87–92.
- Perazzio, S.F.; Granados, Á.; Salomão, R.; et al. High frequency of immunodeficiency-like states in systemic lupus erythematosus: a cross-sectional study in 300 consecutive patients. Rheumatology 2016, 55, 1647–1655.
- Lew, J.; Suresh, S.; Corriveau-Bourque, C. A descriptive analysis of autoimmune cytopenias in children with inborn errors of immunity. Paediatr. Child Health 2025, 30, 705–709.
- Merz, L.E.; Story, C.M.; Osei, M.A.; et al. Absolute neutrophil count by Duffy status among healthy Black and African American adults. Blood Adv. 2023, 7, 317–320.
- Ogbue, O.D.; Kewan, T.; Bahaj, W.S.; et al. New approaches to idiopathic neutropenia in the era of clonal hematopoiesis. Exp. Hematol. Oncol. 2023, 12, 42.
- Yu, L.; Li, Y.; Li, W.; et al. Case report: A cyclic neutropenia patient with ELANE mutation accompanied by hemophagocytic lymphohistiocytosis. Front. Immunol. 2024, 15, 1474429.
- Magen, E.; Vinker-Shuster, M.; Merzon, E.; et al. Chronic idiopathic eosinopenia, allergic, and autoimmune disorders. J. Allergy Clin. Immunol. Pract. 2024, 12, 1933–1936.
- Orange, J.S. How I Manage Natural Killer Cell Deficiency. J. Clin. Immunol. 2020, 40, 13–23.
- Cho, Y.N.; Kee, S.J.; Lee, S.J.; et al. Numerical and functional deficiencies of natural killer T cells in systemic lupus erythematosus: their deficiency related to disease activity. Rheumatology 2011, 50, 1054–1063.
- Belohlavkova, P.; Hrochova, K.; Fatorova, I.; et al. MonoMAC syndrome with GATA2 novel mutation: A case report. Leuk. Res. Rep. 2022, 18, 100346.
- Milligan, K.L.; Mann, D.; Rump, A.; et al. Complete Myeloperoxidase Deficiency: Beware the "False-Positive" Dihydrorhodamine Oxidation. J. Pediatr. 2016, 176, 204–206.
- Cappelletti, P.; Doretto, P.; Signori, D.; et al. Eosinophilic peroxidase deficiency. Cytochemical and ultrastructural characterization of 21 new cases. Am. J. Clin. Pathol. 1992, 98, 615–622.
- Merselis, L.C.; Jiang, S.Y.; Nelson, S.F.; et al. MPEG1/Perforin-2 Haploinsufficiency Associated Polymicrobial Skin Infections and Considerations for Interferon-γ Therapy. Front. Immunol. 2020, 11, 601584.
- van de Winkel, J.G.; de Wit, T.P.; Ernst, L.K.; et al. Molecular basis for a familial defect in phagocyte expression of IgG receptor I (CD64). J. Immunol. 1995, 154, 2896–2903.
- Rauscher, C.K.; Fajt, M.L.; Bryk, J.; et al. Clinical implications of C6 complement component deficiency. Allergy Asthma Proc. 2020, 41, 386–388.
- Balduit, A.; Bianco, A.M.; Mangogna, A.; et al. Genetic bases of C7 deficiency: systematic review and report of a novel deletion determining functional hemizygosity. Front. Immunol. 2023, 14, 1192690.
- Lamb, E.R.; Criss, A.K. Terminal complement complexes with or without C9 potentiate antimicrobial activity against Neisseria gonorrhoeae. mBio 2025, 16, e0014125.
- Zheng, G.; Zhang, J.; Peng, K.; et al. Complement C9 deficiency as a novel risk factor for invasive Candida esophagitis in children: a single case in-depth analysis. BMC Pediatr. 2026, 26, 293. DOI: https://doi.org/10.1186/s12887-026-06681-1
- Oliveira Cavalcanti, E.; Freitas Lidani, K.C.; de Freitas Oliveira Toré, C.; et al. MASP1 Gene Polymorphism and MASP-3 Serum Levels in Patients with Chronic Chagas Disease. Immunol. Invest. 2022, 51, 2108–2121.
- Tereshchenko, S.Y.; Smolnikova, M.V.; Freidin, M.B. Ficolin-3 and MASP-2 gene variants in Siberian arctic populations: Summarized evidence of selective pressure for the high frequency of lectin complement pathway deficiency. Scand. J. Immunol. 2023, 97, e13249.
- Moschese, V.; Graziani, S.; Avanzini, M.A.; et al. A prospective study on children with initial diagnosis of transient hypogammaglobulinemia of infancy: results from the Italian Primary Immunodeficiency Network. Int. J. Immunopathol. Pharmacol. 2008, 21, 343–352.
- Suárez-Cuartín, G.; Lores, C.; Gomez-Olivas, J.D.; et al. Primary Humoral Immunodeficiencies and Bronchiectasis in Adults. J. Clin. Med. 2025, 15, 179.
- Ozdemir, E.; Karaselek, M.A.; Guner, S.N.; et al. Pediatric selective IgM deficiency: clinical features and a preliminary risk index for immunoglobulin replacement therapy. Immunol. Res. 2025, 73, 175.
- Janssen, L.M.A.; Macken, T.; Creemers, M.C.W.; et al. Truly selective primary IgM deficiency is probably very rare. Clin. Exp. Immunol. 2018, 191, 203–211.
- Filion, C.A.; Taylor-Black, S.; Maglione, P.J.; et al. Differentiation of Common Variable Immunodeficiency From IgG Deficiency. J. Allergy Clin. Immunol. Pract. 2019, 7, 1277–1284.
- Imam, K.; Huang, J.; White, A.A. Isotype deficiencies (IgG subclass and selective IgA, IgM, IgE deficiencies). Allergy Asthma Proc. 2024, 45, 317–320.
- Barton, J.C.; Barton, J.C.; Bertoli, L.F.; et al. Characterization of adult patients with IgG subclass deficiency and subnormal IgG2. PLoS One 2020, 15, e0240522.
- Barton, J.C.; Bertoli, L.F.; Barton, J.C.; et al. Selective subnormal IgG3 in 121 adult index patients with frequent or severe bacterial respiratory tract infections. Cell. Immunol. 2016, 299, 50–57.
- Jeraiby, M.A. Molecular basis of immunoglobulin heavy constant G4 gene (IGHG4)-related low serum IgG4 subclasses in Down syndrome. Saudi Med. J. 2021, 42, 975–980.
- Hua, L.; Guo, D.; Liu, X.; et al. Selective IgA Deficiency with Multiple Autoimmune Comorbidities: A Case Report and Literature Review. Iran. J. Immunol. 2023, 20, 232–239.
- Canales-Herrerias, P.; Garcia-Carmona, Y.; Shang, J.; et al. Selective IgA2 deficiency in a patient with small intestinal Crohn's disease. J. Clin. Invest. 2023, 133, e167742.
- Polosukhin, V.V.; Richmond, B.W.; Du, R.H.; et al. Secretory IgA Deficiency in Individual Small Airways Is Associated with Persistent Inflammation and Remodeling. Am. J. Respir. Crit. Care Med. 2017, 195, 1010–1021.
- Magen, E.; Schlesinger, M.; David, M. Selective IgE deficiency, immune dysregulation, and autoimmunity. Allergy Asthma Proc. 2014, 35, e27–e33.
- Türk, M.; Yılmaz, İ. From Selective Immunoglobulin E (IgE) Deficiency to Primary Immunodeficiencies Coexisting with Chronic Spontaneous Urticaria: A Call for Immunological Survey. J. Clin. Pract. Res. 2025, 47, 642–643.
- Fraser, P.A.; Schur, P.H. Hypoimmunoglobulinemia D: frequency, family studies, and association with HLA. Clin. Immunol. Immunopathol. 1981, 19, 67–74.
- Zhang, Y.; Hou, Y.; Yu, M.; et al. IgD in nucleus of pro-B cells promotes pro-B cells proliferation by regulating E2F3 expression. Cell Biosci. 2025, 15, 149.
- Hatcher, V.R.; Alix, V.C.; Hellu, T.S.; et al. Primary Immunodeficiency: Specific antibody deficiency with normal IgG. Allergy Asthma Proc. 2024, 45, 321–325.
- Rahiminejad, M.S.; Mirmohammad Sadeghi, M.; Mohammadinejad, P.; et al. Evaluation of humoral immune function in patients with chronic idiopathic thrombocytopenic purpura. Iran. J. Allergy Asthma Immunol. 2013, 12, 50–56.
- Fasshauer, M.; Dinges, S.; Staudacher, O.; et al. Monogenic Inborn Errors of Immunity with impaired IgG response to polysaccharide antigens but normal IgG levels and normal IgG response to protein antigens. Front. Pediatr. 2024, 12, 1386959.
- Plebani, A.; Carbonara, A.O.; Bottaro, A.; et al. Two siblings with deficiency of IgA1, IgG2, IgG4 and IgE due to deletion of immunoglobulin heavy chain constant region genes. Year Immunol. 1993, 7, 231–235.
- Drygiannakis, I.; Theodoraki, E.; Tsafaridou, M.; et al. Crohn's Disease-Like Features in a Patient With IgE and Selective IgG1 and IgG3 Deficiency. Cureus 2023, 15, e34655.
- Castillo-Sigales, A.A.; Acuatla-Munguia, P.; Palafox-Olvera, A.; et al. Primary immunodeficiency with hypogammaglobulinemia and minimum midline defect. Rev. Alerg. Mex. 2025, 72, 100. (in Spanish)
- Régent, A.; Autran, B.; Carcelain, G.; et al. Idiopathic CD4 lymphocytopenia: clinical and immunologic characteristics and follow-up of 40 patients. Medicine 2014, 93, 61–72.
- Wang, T.; Liu, S.; Liang, X.; et al. Lupus nephritis association with idiopathic CD4 + T lymphocytopenia: a case report of a young man with recalcitrant warts. BMC Nephrol. 2025, 26, 381.
- Soomann, M.; Prader, S.; Agyeman, P.K.A.; et al. Natural History of Swiss Infants with Non-SCID T-cell Lymphopenia Detected by Newborn Screening: A Cohort Study. J. Clin. Immunol. 2025, 45, 166.
- de la Calle-Martin, O.; Hernandez, M.; Ordi, J.; et al. Familial CD8 deficiency due to a mutation in the CD8 alpha gene. J. Clin. Invest. 2001, 108, 117–123.
- Mackley, M.P.; Brager, R.; Geddie, H.; et al. Expanding Phenotype of GINS1 Deficiency: A Case Report and Review of the Literature. Clin. Genet. 2026. DOI: https://doi.org/10.1111/cge.70147
- Stea, E.D.; Pesce, F.; Bari, I.D.; et al. MBL2 deficiency and IgA Nephropathy in transplant patients: Is complement inhibition always beneficial? Eur. J. Intern. Med. 2026, 106765.
- Markocsy, A.; Kapustová, D.; Čereš, A.; et al. Atypical Manifestation of X-linked Agammaglobulinemia - the Importance of Genetic Testing. Acta Medica 2024, 67, 60–63.
- Naor, S.; Schiby, G.; Adam, E.; et al. Abnormal immunoglobulin expression and B-cell follicle organization in inborn errors of immunity/primary immunodeficiency. Virchows Arch. 2025. DOI: https://doi.org/10.1007/s00428-025-04378-x
- Florova, M.; Abreu-Mota, T.; Paesen, G.C.; et al. Central tolerance shapes the neutralizing B cell repertoire against a persisting virus in its natural host. Proc. Natl. Acad. Sci. U.S.A. 2024, 121, e2318657121.
- Rimland, C.A.; Lam, M.T.; Lee, P.Y. DOCK8 at the crossroads of immunodeficiency and hyperinflammation. J. Allergy Clin. Immunol. 2025, 155, 1199–1201.
- Ho, H.E.; Radigan, L.; Meffre, E.; et al. IgA defects in CVID lead to bacterial translocation, increased serum γ-interferon, and BAFF. J. Hum. Immun. 2026, 2, e20250080.
- Conrey, P.E.; Denu, L.; O'Boyle, K.C.; et al. IgA deficiency destabilizes homeostasis toward intestinal microbes and increases systemic immune dysregulation. Sci. Immunol. 2023, 8, eade2335.
- Sogkas, G.; Dubrowinskaja, N.; Adriawan, I.R.; et al. High frequency of variants in genes associated with primary immunodeficiencies in patients with rheumatic diseases with secondary hypogammaglobulinaemia. Ann. Rheum. Dis. 2021, 80, 392–399.
- Donald, K.; Petersen, C.; Turvey, S.E.; et al. Secretory IgA: Linking microbes, maternal health, and infant health through human milk. Cell Host Microbe 2022, 30, 650–659.
- Dong, L.; Jiang, H.; Chen, K.; et al. Mannan-Binding Lectin Deficiency Limits Inflammation-induced Myeloid-Derived Suppressor Cells Expansion via Modulating Tumor Necrosis Factor Alpha-triggered Apoptosis. Int. J. Biol. Sci. 2022, 18, 1580–1593.
- Timofeeva, A.M.; Sedykh, S.E.; Nevinsky, G.A. Anti-Idiotypic Antibodies in Immune Regulation and Disease: Therapeutic Promise for Next-Generation Vaccines. Vaccines 2025, 13, 1224.
- Halma, C.; Daha, M.R.; van der Meer, J.W.; et al. Effect of monomeric immunoglobulin G (IgG) on the clearance of soluble aggregates of IgG in man. J. Clin. Lab. Immunol. 1991, 35, 9–15.
- Tavares Dantas, A.; Rodrigues de Almeida, A.; Ferraz Cordeiro, M.; et al. Thiazolidine derivative (LPSF/CR-35) modulates the production of IL-17A, IL-10, IL-4, TFN, CCL2 and CXCL8 in PBMC from systemic sclerosis patients. Pharmacol. Rep. 2026, 78, 292–302.
- Zhou, Z.; Lourens, M.S.; Meesilpavikkai, K.; et al. Gain-of-Function Variant in STAT3 and Retinal Macular Edema: Insights into the IL-6R/JAK/STAT3 Pathway in Retinal Pigment Epithelium. Ocul. Immunol. Inflamm. 2025, 34, 1–15.
- Luo, X.; Xu, L.; Cai, J.; et al. CMTM6 promotes synovial proliferation and macrophage polarization by preventing ubiquitination of TAK1 in rheumatoid arthritis. J. Orthop. Transl. 2026, 56, 101005.
- Bagheri, Y.; Sanaei, R.; Yazdani, R.; et al. The Heterogeneous Pathogenesis of Selective Immunoglobulin A Deficiency. Int. Arch. Allergy Immunol. 2019, 179, 231–246.
- Nagieva, S.; Smirnikhina, S. Allogeneic Hematopoietic Stem Cell Transplantation as a Therapeutic Approach for Hereditary Diseases. Biomedicines 2025, 13, 2903.
- Ballow, M.; Leiding, J.W. Precision Medicine in the Treatment of Primary Immune Deficiency Patients With Disorders of Immune Dysregulation. Clin Rev Allergy Immunol. 2022, 63, 1–8.
- Grumach, A.S.; Goudouris, E.S. Inborn Errors of Immunity: how to diagnose them? J. Pediatr. 2021, 97, S84–S90.
- Borg Azzopardi, D.; Vella, A.; Ceci Bonello, E.; et al. SRP54-related congenital neutropenia: a multidisciplinary effort. BMJ Case Rep. 2026, 19, e270598.
- Zhuo, L.; Ma, P.; Chen, M.; et al. Novel pathogenic variant in the deficiency in ELF4, X-linked (DEX): case report and literature review. Orphanet J. Rare Dis. 2025, 20, 535.
- Batista, C.H.R.; Smanio, M.C.M.; Poltronieri, P.B.; et al. Selective IgM deficiency: evaluation of 75 patients according to different diagnostic criteria. Immunol. Res. 2024, 73, 15.
- Eigenmann, P.A.; Ambinder, R.F.; Lederman, H.M. Chronic sinusitis with acquired immunoglobulin A (IgA) deficiency after bone marrow transplantation. Otolaryngol. Head Neck Surg. 1997, 117, S226–S228.
- Liu, S.; Ma, S.; Liu, G.; et al. CK2B Induces CD8 + T-Cell Exhaustion through HDAC8-Mediated Epigenetic Reprogramming to Limit the Efficacy of Anti-PD-1 Therapy in Non-Small-Cell Lung Cancer. Adv. Sci. 2025, 12, e2411053.
- Zhang, J.; van Oostrom, D.; Li, J.; et al. Innate Mechanisms in Selective IgA Deficiency. Front. Immunol. 2021, 12, 649112.
- Hammarström, L.; Smith, C.I. Development of IgG2 deficiency in a bone-marrow-transplanted patient. Transplantation 1987, 43, 917–919.
- Abedi, M.R.; Hammarström, L.; Ringdén, O.; et al. Development of IgA deficiency after bone marrow transplantation. Transplantation 1990, 50, 415–421.
- Krance, R.A.; Spruce, W.E.; Forman, S.J.; et al. Human cyclic neutropenia transferred by allogeneic bone marrow grafting. Blood 1982, 60, 1263–1266.
- Freiberger, T.; Litzman, J.; Vondrusková, E. Role of aspartic acid at position 57 of the HLA-DQ beta chain in sporadic and familial forms of selective IgA deficiency. Cas Lek. Cesk. 2001, 140, 770–773.
- Alajmi, A.; Alsharidah, S.; Khalifa, N.; et al. Spectrum of Primary Immune Regulatory Disorders in Children in a Highly Consanguineous Population: Report from a National Registry. J. Clin. Immunol. 2026, 46, 25.
- El Sissy, C.; Rosain, J.; Vieira-Martins, P.; et al. Clinical and Genetic Spectrum of a Large Cohort With Total and Sub-total Complement Deficiencies. Front. Immunol. 2019, 10, 1936.
- Hogendorf, A.; Szymańska, M.; Krasińska, J.; et al. Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency. Pediatr. Diabetes 2021, 22, 707–716.
- Moschese, V.; Chini, L.; Graziani, S.; et al. Follow-up and outcome of symptomatic partial or absolute IgA deficiency in children. Eur. J. Pediatr. 2019, 178, 51–60.
- Koenen, M.H.; van Montfrans, J.M.; Sanders, E.A.M.; et al. Immunoglobulin A deficiency in children, an undervalued clinical issue. Clin. Immunol. 2019, 209, 108293.
- Živković, J.; Lipej, M.; Banić, I.; et al. Respiratory and allergic disorders in children with severe and partial immunoglobulin A immunodeficiency. Scand. J. Immunol. 2019, 90, e12828.
- Perazzio, S.F.; Silva, N.P.; Carneiro-Sampaio, M.; et al. Mild and moderate Mannose Binding Lectin deficiency are associated with systemic lupus erythematosus and lupus nephritis in Brazilian patients. Rev. Bras. Reumatol. 2016, 56, 220–227.
- Bertoli, L.F.; Pappas, D.G.; Barton, J.C.; et al. Serum immunoglobulins in 28 adults with autoimmune sensorineural hearing loss: increased prevalence of subnormal immunoglobulin G1 and immunoglobulin G3. BMC Immunol. 2014, 15, 43.
- Tudhope, S.J.; von Delwig, A.; Falconer, J.; et al. Profound invariant natural killer T-cell deficiency in inflammatory arthritis. Ann. Rheum. Dis. 2010, 69, 1873–1879.
- Green, M.R.; Kennell, A.S.; Larche, M.J.; et al. Natural killer cell activity in families of patients with systemic lupus erythematosus: demonstration of a killing defect in patients. Clin. Exp. Immunol. 2005, 141, 165–173.
- Smith, J.K.; Krishnaswamy, G.H.; Dykes, R.; et al. Clinical manifestations of IgE hypogammaglobulinemia. Ann. Allergy Asthma Immunol. 1997, 78, 313–318.
- Barton, J.C.; Bertoli, L.F.; Barton, J.C.; et al. Selective Subnormal IgG1 in 54 Adult Index Patients with Frequent or Severe Bacterial Respiratory Tract Infections. J. Immunol. Res. 2016, 1405950.
- Orren, A.; Würzner, R.; Potter, P.C.; et al. Properties of a low molecular weight complement component C6 found in human subjects with subtotal C6 deficiency. Immunology 1992, 75, 10–16.
- Sgrulletti, M.; Costagliola, G.; Giardino, G.; et al. The Evolutionary Scenario of Pediatric Unclassified Primary Antibody Deficiency to Adulthood. J. Clin. Med. 2023, 12, 4206.
- Jolles, S.; Tyrer, M.; Johnson, M.; et al. Long term recovery of IgG and IgM production during HIV infection in a patient with common variable immunodeficiency. J. Clin. Pathol. 2001, 54, 713–715.
- Lim, C.K.; Dahle, C.; Elvin, K.; et al. Reversal of Immunoglobulin A Deficiency in Children. J. Clin. Immunol. 2015, 35, 87–91.
- Castigli, E.; Wilson, S.A.; Garibyan, L.; et al. TACI is mutant in common variable immunodeficiency and IgA deficiency. Nat. Genet. 2005, 37, 829–834.
- Joller, P.W.; Buehler, A.K.; Hitzig, W.H. Transitory and persistent IgA deficiency. Reevaluation of 19 pediatric patients once found to be deficient in serum IGA. J. Clin. Lab. Immunol. 1981, 6, 97–101.
- Kazi, A.; Strauch, C.; Roy, S.; et al. Temporal patterns of IgE levels in patients with IgE deficiency. Ann. Allergy Asthma Immunol. 2024, 133, 346–347.
- Desar, I.M.; Weemaes, C.M.; van Deuren, M.; et al. Reversible hypogammaglobulinaemia. Neth. J. Med. 2007, 65, 381–385.
- Barton, J.C.; Bertoli, L.F.; Barton, J.C. Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients. J. Immunol. Res. 2014, 542706.
- Kelly, P.; Jack, D.L.; Naeem, A.; et al. Mannose-binding lectin is a component of innate mucosal defense against Cryptosporidium parvum in AIDS. Gastroenterology 2000, 119, 1236–1242.
- Erbagci, Z. Noma-like gangrenous cheilitis in a child with cyclic neutropenia associated with myeloperoxidase deficiency. Pediatr. Dermatol. 2003, 20, 519–523.
- Barton, J.C.; Barton, J.C.; Bertoli, L.F. Clinical and laboratory associations of mannose-binding lectin in 219 adults with IgG subclass deficiency. BMC Immunol. 2019, 20, 15.
- Bijker, E.M.; Bateman, E.A.L.; Trück, J.; et al. Screening for Immunodeficiencies in Children With Invasive Pneumococcal Disease: Six-year Experience From a UK Children’s Hospital. Pediatr. Infect. Dis. J. 2022, 41, 575–578.
- Nahum, A.; Somech, R.; Shubinsky, G.; et al. Unusual phenotype in patients with a hypomorphic mutation in the DCLRE1C gene: IgG hypergammaglobulinemia with IgA and IgE deficiency. Clin. Immunol. 2020, 213, 108366.
- Jiménez, A.; Alvarez-Doforno, R.; García Rodríguez, M.C.; et al. Autoantibodies in patients with IgA and IgG2 deficiencies. APMIS 1991, 99, 327–332.
- Janssen, L.M.A.; Reijnen, I.C.G.M.; Milito, C.; et al. Protocol for the unclassified primary antibody deficiency (unPAD) study: Characterization and classification of patients using the ESID online Registry. PLoS One 2022, 17, e0266083.
- Picado, C.; de Landazuri, I.O.; Vlagea, A.; et al. Spectrum of Disease Manifestations in Patients with Selective Immunoglobulin E Deficiency. J. Clin. Med. 2021, 10, 4160.
- Schoettler, J.J.; Schleissner, L.A.; Heiner, D.C. Familial IgE deficiency associated with sinopulmonary disease. Chest 1989, 96, 516–521.
- Papadea, C.; Check, I.J. Human immunoglobulin G and subclasses: biochemical, genetic, and clinical aspects. Crit. Rev. Clin. Lab. Sci. 1989, 27, 27–58.
- Park, J.K.; Kim, D.; Lee, J.M.; et al. Clinical Utility of Personalized Serum IgG Subclass Ratios for the Differentiation of IgG4-Related Sclerosing Cholangitis (IgG4-SC) from Primary Sclerosing Cholangitis (PSC) and Cholangiocarcinoma (CCA). J. Pers. Med. 2022, 12, 855.
- Eriksson, P.; Almroth, G.; Denneberg, T.; et al. IgG2 Deficiency in Primary Sjögren's Syndrome and Hypergammaglobulinemic Purpura. Clin. Immunol. Immunopathol. 1994, 70, 60–65.
- Potlukova, E.; Freiberger, T.; Limanova, Z.; et al. Association between low levels of Mannan-binding lectin and autoimmune thyroid disease in pregnancy. PLoS One 2013, 8, e81755.
- Potlukova, E.; Jiskra, J.; Freiberger, T.; et al. The production of mannan-binding lectin is dependent upon thyroid hormones regardless of the genotype: A cohort study of 95 patients with autoimmune thyroid disorders. Clin. Immunol. 2010, 136, 123–129.
- Aghamohammadi, A.; Cheraghi, T.; Gharagozlou, M.; et al. IgA deficiency: correlation between clinical and immunological phenotypes. J. Clin. Immunol. 2009, 29, 130–136.
- Gulez, N.; Karaca, N.E.; Aksu, G.; et al. Increased percentages of autoantibodies in immunoglobulin A-deficient children do not correlate with clinical manifestations. Autoimmunity 2009, 42, 74–79.
- Jönsson, G.; Oxelius, V.A.; Truedsson, L.; et al. Homozygosity for the IgG2 subclass allotype G2M(n) protects against severe infection in hereditary C2 deficiency. J. Immunol. 2006, 177, 722–728.
- Barka, N.; Shen, G.Q.; Shoenfeld, Y.; et al. Multireactive pattern of serum autoantibodies in asymptomatic individuals with immunoglobulin A deficiency. Clin. Diagn. Lab. Immunol. 1995, 2, 469–472.
- Conrey, P.E.; Denu, L.; O’Boyle, K.C.; et al. IgA deficiency destabilizes homeostasis toward intestinal microbes and increases systemic immune dysregulation. Sci. Immunol. 2023, 8, eade2335.
- Koskinen, S. Long-term follow-up of health in blood donors with primary selective IgA deficiency. J. Clin. Immunol. 1996, 16, 165–170.
- Bogunovic, D. Incomplete penetrance in inborn errors of immunity: A skeleton in the closet-The sequel. J. Hum. Immun. 2025, 1, e20250064.
- Erkoçoğlu, M.; Metin, A.; Kaya, A.; et al. Allergic and autoimmune disorders in families with selective IgA deficiency. Turk. J. Med. Sci. 2017, 47, 592–598.
- Johnson, M.L.; Keeton, L.G.; Zhu, Z.B.; et al. Age-related changes in serum immunoglobulins in patients with familial IgA deficiency and common variable immunodeficiency (CVID). Clin. Exp. Immunol. 1997, 108, 477–483.
- Yazdani, R.; Latif, A.; Tabassomi, F.; et al. Clinical phenotype classification for selective immunoglobulin A deficiency. Expert Rev. Clin. Immunol. 2015, 11, 1245–1254.
- Yuan, Z.C.; Xu, W.D.; Lan, Y.Y.; et al. Association of MBL2 gene polymorphisms and systemic lupus erythematosus susceptibility: A meta-analysis. Int. J. Rheum. Dis. 2021, 24, 147–158.
- Mahto, H.; Pati, A.; Sahu, S.K.; et al. Association of MBL-2 gene polymorphisms with systemic lupus erythematosus: an updated meta-analysis and trial sequential analysis. Lupus 2020, 29, 1227–1237.
- Bayati, P.; Neamah, D.H.; Bagheri, Y.; et al. Elevated IL-27 and altered anti-inflammatory cytokine levels in SLE patients with end-stage renal disease. Clin. Biochem. 2026, 143, 111106.
- Ferreira, R.C.; Pan-Hammarström, Q.; Graham, R.R.; et al. Association of IFIH1 and other autoimmunity risk alleles with selective IgA deficiency. Nat. Genet. 2010, 42, 777–780.
- Poddighe, D.; Capittini, C. The Role of HLA in the Association between IgA Deficiency and Celiac Disease. Dis. Markers 2021, 2021, 8632861.
- Vorechovský, I.; Webster, A.D.; Plebani, A.; et al. Genetic Linkage of IgA Deficiency to the Major Histocompatibility Complex: Evidence for Allele Segregation Distortion, Parent-of-Origin Penetrance Differences, and the Role of Anti-IgA Antibodies in Disease Predisposition. Am. J. Hum. Genet. 1999, 64, 1096–1109.
- Singh, K.; Chang, C.; Gershwin, M.E. IgA deficiency and autoimmunity. Autoimmun. Rev. 2014, 13, 163–177.
- Shimamura, Y.; Maeda, T.; Abe, K.; et al. Selective immunoglobulin M deficiency complicated by systemic lupus erythematosus and antiphospholipid syndrome: a case report and review of literature. CEN Case Rep. 2021, 10, 435–441.
- Baleva, M.P.; Mihaylova, S.; Yankova, P.; et al. A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency. Cent. Eur. J. Immunol. 2016, 41, 217–220.
- Tanha, N.; Troelsen, L.; From Hermansen, M.L.; et al. MBL2 gene variants coding for mannose-binding lectin deficiency are associated with increased risk of nephritis in Danish patients with systemic lupus erythematosus. Lupus 2014, 23, 1105–1111.
- Ramos-Casals, M.; Brito-Zerón, P.; Soria, N.; et al. Mannose-binding lectin-low genotypes are associated with milder systemic and immunological disease expression in primary Sjogren's syndrome. Rheumatology (Oxford) 2009, 48, 65–69.
- Nasr, I.; Al Kindi, M.; Al Abri, S.; et al. Selective Immunoglobulin A Deficiency Among Omani Patients Screened for Celiac Disease: A Cross-sectional Study. Oman Med. J. 2025, 40, e731.
- Kojo, S.; Adachi, Y.; Keino, H.; et al. Dysfunction of T cell receptor AV24AJ18+,BV11+ double-negative regulatory natural killer T cells in autoimmune diseases. Arthritis Rheum. 2001, 44, 1127–1138.
- Fahl, K.; Silva, C.A.; Pastorino, A.C.; et al. Autoimmune diseases and autoantibodies in pediatric patients and their first-degree relatives with immunoglobulin A deficiency. Rev. Bras. Reumatol. 2015, 55, 197–202.
- Ballow, M.; Sánchez-Ramón, S.; Walter, J.E. Secondary Immune Deficiency and Primary Immune Deficiency Crossovers: Hematological Malignancies and Autoimmune Diseases. Front. Immunol. 2022, 13, 928062.
- Labrosse, R.; Barmettler, S.; Derfalvi, B.; et al. Rituximab-induced hypogammaglobulinemia and infection risk in pediatric patients. J. Allergy Clin. Immunol. 2021, 148, 523–532.
- Suyama, K.; Kawasaki, Y.; Abe, Y.; et al. Development of common variable immunodeficiency in IgA- and IgG2-deficient patients with systemic lupus erythematosus. Pediatr. Nephrol. 2012, 27, 489–492.
- Engel, E.R.; Walter, J.E. Rituximab and eculizumab when treating nonmalignant hematologic disorders: infection risk, immunization recommendations, and antimicrobial prophylaxis needs. Hematol. Am. Soc. Hematol. Educ. Program 2020, 2020, 312–318.
- Otani, I.M.; Lehman, H.K.; Jongco, A.M.; et al. Practical guidance for the diagnosis and management of secondary hypogammaglobulinemia: A Work Group Report of the AAAAI Primary Immunodeficiency and Altered Immune Response Committees. J. Allergy Clin. Immunol. 2022, 149, 1525–1560.
- Ottaviano, G.; Sgrulletti, M.; Moschese, V. Secondary rituximab-associated versus primary immunodeficiencies: The enigmatic border. Eur. J. Immunol. 2022, 52, 1572–1580.
- Jesus, A.A.; Jacob, C.M.; Silva, C.A.; et al. Common Variable Immunodeficiency Associated with Hepatosplenic T-Cell Lymphoma Mimicking Juvenile Systemic Lupus Erythematosus. Clin. Dev. Immunol. 2011, 2011, 428703.
- Guarino, A.D.; Luglio, G.; Imperatore, N.; et al. Cyclic Neutropenia Mimicking Crohn’s Disease: Two Case Reports and a Narrative Review. J. Clin. Med. 2023, 12, 6323.
- Goldstein, R.; Karsh, J. Transition of SLE to common variable hypogammaglobulinemia. Am. J. Med. 1990, 88, 554.
- Baum, C.G.; Chiorazzi, N.; Frankel, S.; et al. Conversion of systemic lupus erythematosus to common variable hypogammaglobulinemia. Am. J. Med. 1989, 87, 449–456.
- Zhang, C.; Zhu, J.; Li, S.L.; et al. The association of mannose-binding lectin genetic polymorphisms with the risk of rheumatoid arthritis: a meta-analysis. J. Recept. Signal Transduct. Res. 2015, 35, 357–362.
- Song, G.G.; Bae, S.C.; Seo, Y.H.; et al. Meta-analysis of MBL polymorphisms. Z. Rheumatol. 2014, 73, 657–664.
- El Alami, H.; Bouqdayr, M.; Errafii, K.; et al. Association of MBL2 gene polymorphisms with type 2 diabetes and its complications in Moroccan population. Nucleosides Nucleotides Nucleic Acids 2026, 45, 131–152.
- Kaur, T.; Kashyap, S.S.; Arora, S.; et al. Mannose-Binding Lectin Gene Variants as Disease Susceptibility Biomarkers in Rheumatoid Arthritis. Genet. Test. Mol. Biomarkers 2024, 28, 360–366.
- Jahan, I.; Hayat, S.; Khalid, M.M.; et al. Association of mannose-binding lectin 2 gene polymorphisms with Guillain-Barré syndrome. Sci. Rep. 2022, 12, 5791.
- Werth, V.P.; Berlin, J.A.; Callen, J.P.; et al. Mannose Binding Lectin (MBL) Polymorphisms Associated with Low MBL Production in Patients with Dermatomyositis. J. Invest. Dermatol. 2002, 119, 1394–1399.
- Im, C.H.; Kim, J.; Lee, Y.J.; et al. Mannose-binding lectin 2 gene haplotype analysis in Korean patients with ankylosing spondylitis. Rheumatol. Int. 2012, 32, 2251–2255.
- Kovacs, M.; Papp, M.; Lakatos, P.L.; et al. Low mannose-binding lectin (MBL) is associated with paediatric inflammatory bowel diseases and ileal involvement in patients with Crohn disease. J. Crohns Colitis 2013, 7, 134–141.
- Kubicka-Trzaska, A. Immunologic disturbances in patients with idiopathic posterior uveitis. Klin. Oczna 2000, 102, 253–258.
- Cuadrado, M.J.; Calatayud, I.; Urquizu-Padilla, M.; et al. Immunoglobulin abnormalities are frequent in patients with lupus nephritis. BMC Rheumatol. 2019, 3, 30.
- Ludvigsson, J.F.; Neovius, M.; Hammarström, L. Association Between IgA Deficiency & Other Autoimmune Conditions: A Population-Based Matched Cohort Study. J. Clin. Immunol. 2014, 34, 444–451.
- Odineal, D.D.; Gershwin, M.E. The Epidemiology and Clinical Manifestations of Autoimmunity in Selective IgA Deficiency. Clin. Rev. Allergy Immunol. 2020, 58, 107–133.
- Wang, N.; Shen, N.; Vyse, T.J.; et al. Selective IgA deficiency in autoimmune diseases. Mol. Med. 2011, 17, 1383–1396.
- Güngören, E.Y.; Çalışkan, N.; Özkalkan, B.; et al. Insights into the clinical spectrum of selective IgA deficiency: Data from two centers. Allergol. Immunopathol. 2025, 53, 32–37.
- Ni, J.; Zhang, J.; Chen, Q.; et al. The epidemiology and clinical features of selective immunoglobulin M deficiency: A single‐center study in China. J. Clin. Lab. Anal. 2020, 34, e23289.
- Caka, C.; Cimen, O.; Kahyaoğlu, P.; et al. Selective IgM deficiency: Follow-up and outcome. Pediatr. Allergy Immunol. 2021, 32, 1327–1334.
- Lucuab-Fegurgur, D.L.; Gupta, S. Comprehensive clinical and immunological features of 62 adult patients with selective primary IgM deficiency. Am. J. Clin. Exp. Immunol. 2019, 8, 55–67.
- Goldstein, M.F.; Goldstein, A.L.; Dunsky, E.H.; et al. Selective IgM immunodeficiency: retrospective analysis of 36 adult patients with review of the literature. Ann. Allergy Asthma Immunol. 2006, 97, 717–730.
- Yel, L.; Ramanuja, S.; Gupta, S. Clinical and immunological features in IgM deficiency. Int. Arch. Allergy Immunol. 2009, 150, 291–298.
- Barton, J.C.; Barton, J.C.; Bertoli, L.F. Hydroxychloroquine therapy and serum immunoglobulin levels in women with IgG subclass deficiency and systemic lupus erythematosus, Sjögren syndrome, and rheumatoid arthritis: a retrospective study. Arch. Immunol. Ther. Exp. 2022, 70, 14.
- Oxelius, V.A.; Hanson, L.A.; Björkander, J.; et al. IgG3 deficiency common in obstructive lung disease Hereditary in families with immunodeficiency and autoimmune disease. In Immunoglobulin Subclass Deficiencies (Monographs in Allergy); S Karger Ag: Basel, Switzerland; New York, NY, USA, 1986; pp. 106–115.
- Shin, J.J.; Liauw, D.; Siddiqui, S.; et al. Immunological and clinical phenotyping in primary antibody deficiencies: a growing disease spectrum. J. Clin. Immunol. 2020, 40, 592–601.
- Gerek, M.E.; Colkesen, F.; Onalan, T.; et al. Comparative analysis of demographic and clinical features in common variable immunodeficiency and selective immunoglobulin G deficiency. Allergy Asthma Proc. 2025, 46, 498–505.
- Dogru, D.; Dogru, Y.; Atschekzei, F.; et al. Reappraisal of IgG subclass deficiencies: a retrospective comparative cohort study. Front. Immunol. 2025, 16, 1552513.
- Lacombe, C.; Aucouturier, P.; Preud'homme, J.L. Selective IgG1 deficiency. Clin. Immunol. Immunopathol. 1997, 84, 194–201.
- Khokar, A.; Gupta, S. Clinical and immunological features of 78 adult patients with primary selective IgG subclass deficiencies. Arch. Immunol. Ther. Exp. 2019, 67, 325–334.
- Khil'chenko, S.; Boch, K.; van Beek, N.; et al. Alterations of total serum immunoglobulin concentrations in pemphigus and pemphigoid: selected IgG2 deficiency in bullous pemphigoid. Front. Med. 2020, 7, 472.
- Al, S.; Asilsoy, S.; Uzuner, N.; et al. Is there a clinical significance of very low serum immunoglobulin E level? J. Clin. Immunol. 2021, 41, 1893–1901.
- Nemet, S.; Elbirt, D.; Cohen, R.; et al. IgE deficiency (<2.5 IU/mL) in children: clinical insights from a population-based study of 123,393 subjects. Pediatr. Allergy Immunol. 2025, 36, e70092.
- Zhang, J.; Ni, J.; Kong, W.; et al. Various clinical manifestations of 223 patients with IgE deficiency in a tertiary hospital in China: a cross-sectional study. Medicine (Baltimore) 2024, 103, e38397.
- Ünsal, H.; Ekinci, A.; Aliyeva, G.; et al. Characteristics of patients with low serum IgE levels and selective IgE deficiency: data from an immunodeficiency referral center. Clin. Immunol. 2025, 270, 110403.
- Gerek, M.E.; Colkesen, F.; Onalan, T.; et al. Selective immunoglobulin E deficiency and its association with autoimmune and autoinflammatory diseases. Allergy Asthma Proc. 2025, 46, e91–e97.
- Cudrici, C.D.; Boulougoura, A.; Sheikh, V.; et al. Characterization of autoantibodies, immunophenotype and autoimmune disease in a prospective cohort of patients with idiopathic CD4 lymphocytopenia. Clin. Immunol. 2021, 224, 108664.
- Perez-Diez, A.; Wong, C.S.; Liu, X.; et al. Prevalence and pathogenicity of autoantibodies in patients with idiopathic CD4 lymphopenia. J. Clin. Invest. 2020, 130, 5326–5337.
- Ahmad, D.S.; Esmadi, M.; Steinmann, W.C. Idiopathic CD4 lymphocytopenia: spectrum of opportunistic infections, malignancies, and autoimmune diseases. Avicenna J. Med. 2013, 3, 37–47.
- Mandl, T.; Bredberg, A.; Jacobsson, L.T.; et al. CD4 + T-lymphocytopenia - a frequent finding in anti-SSA antibody seropositive patients with primary Sjögren's syndrome. J. Rheumatol. 2004, 31, 726–728.
- Kirtava, Z.; Blomberg, J.; Bredberg, A.; et al. CD4 + T-lymphocytopenia without HIV infection: increased prevalence among patients with primary Sjögren's syndrome. Clin. Exp. Rheumatol. 1995, 13, 609–611.
- Patıroğlu, T.; Eke Güngör, H.; Belohradsky, J.S.; et al. Myeloperoxidase deficiency: the secret under the flag of unstained cell. Turk. J. Haematol. 2013, 30, 232–233.
- Bell, A.L.; Markey, G.M.; Alexander, H.D.; et al. Myeloperoxidase deficiency in a patient with rheumatoid arthritis: oxygenation and radical activity by phagocytic cells. Br. J. Rheumatol. 1993, 32, 162–165.
- Ramsaransing, G.; Teelken, A.; Prokopenko, V.M.; et al. Low leucocyte myeloperoxidase activity in patients with multiple sclerosis. J. Neurol. Neurosurg. Psychiatry 2003, 74, 953–955.
- Maltsev, D.V. Effectiveness of long-term continuous immunomodulatory therapy with gamma-recombinant interferon in patients with clinically manifest forms of neutrophil myeloperoxidase deficiency. Arch. Venez. Farmacol. Ter. 2020, 39, 672–679.
- Villanueva, J.; Lee, S.; Giannini, E.H.; et al. Natural killer cell dysfunction is a distinguishing feature of systemic onset juvenile rheumatoid arthritis and macrophage activation syndrome. Arthritis Res. Ther. 2005, 7, R30–R37.
- Gascón, P.; Zoumbos, N.; Young, N. Analysis of natural killer cells in patients with aplastic anemia. Blood 1986, 67, 1349–1355.
- Lee, S.J.; Cho, Y.N.; Kim, T.J.; et al. Natural killer T cell deficiency in active adult-onset Still's disease: correlation of deficiency of natural killer T cells with dysfunction of natural killer cells. Arthritis Rheum. 2012, 64, 2868–2877.
- Wither, J.; Cai, Y.C.; Lim, S.; et al. Reduced proportions of natural killer T cells are present in the relatives of lupus patients and are associated with autoimmunity. Arthritis Res. Ther. 2008, 10, R108.
- Perez, E. Future of therapy for inborn errors of immunity. Clin. Rev. Allergy Immunol. 2022, 63, 75–89.
- Jang, J.H.; Kim, J.H.; Park, H.S. Current issues in the management of IgG subclass deficiencies in adults with chronic respiratory diseases. Allergy Asthma Immunol. Res. 2023, 15, 562–579.
- Collet, A.; de Chambure, D.P.; Moitrot, E.; et al. Non-allergic hypersensitivity reactions to immunoglobulin preparations in antibody deficiencies: what role for anti-IgA IgG and complement activation? Clin. Rev. Allergy Immunol. 2024, 67, 47–57.
- Shehadeh, S.; Betschel, S.; Cameron, D.W.; et al. Immunoglobulin treatment and clinical outcomes: data from the Ontario immunoglobulin treatment program multicenter case registry. Ther. Adv. Hematol. 2025, 16, 1–11.
- Goldstein, M.F.; Hilditch, G.J.; Dvorin, D.J.; et al. Immunoglobulin replacement for selective IgM immunodeficiency, bronchiectasis, and asthma. Ann. Allergy Asthma Immunol. 2016, 116, 172–173.
- Spanò, S.; Licitra, G.; Cucciolini, G.; et al. The efficacy of IgM-enriched immunoglobulin (eIg) administration for treatment of sepsis and septic shock in adult surgical patients: a single-center, retrospective, observational study. J. Clin. Med. 2026, 15, 1526.
- Arduin, L.; Cassir, N.; Coiffard, B. IgA/IgM enriched immunoglobulin therapy for recurrent pulmonary infections in a patient with partial IgA deficiency and lung transplantation. Transpl. Infect. Dis. 2026, e70189.
- Kaveri, S.V.; Maddur, M.S.; Hegde, P.; et al. Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy. Clin. Exp. Immunol. 2011, 164, 2–5.
- Kim, J.H.; Ye, Y.M.; Ban, G.Y.; et al. Effects of immunoglobulin replacement on asthma exacerbation in adult asthmatics with IgG subclass deficiency. Allergy Asthma Immunol. Res. 2017, 9, 526–533.
- Geneviève, M.; Bonnet, F.; Michaux, C.; et al. Lupus nephritis associated with common variable immunodeficiency: favourable outcome with intravenous immunoglobulin treatment. Rev. Med. Interne 2012, 33, e31–e33.
- Zhang, X.; Feng, R.; Shao, M.; et al. Low-dose interleukin-2 as an alternative therapy for refractory lupus nephritis. Rheumatol. Ther. 2021, 8, 1905–1914.
- Su, G.; Lai, J.; Zhu, J.; et al. Analysis of five cases of monogenic lupus related to primary immunodeficiency diseases. Inflamm. Res. 2021, 70, 1211–1216.
- Fata, F.; Myers, P.; Addeo, J.; et al. Cyclic neutropenia in Crohn's ileocolitis: efficacy of granulocyte colony-stimulating factor. J. Clin. Gastroenterol. 1997, 24, 253–256.
- Wilson, C.S.; Hoopes, E.M.; Falk, A.C.; et al. A human IgM enriched immunoglobulin preparation, Pentaglobin, reverses autoimmune diabetes without immune suppression in NOD mice. Sci. Rep. 2022, 12, 11731.
- Malaguarnera, M.; Guccione, N.; Musumeci, S.; et al. Intravenous immunoglobulin plus interferon-alpha in autoimmune hepatitis C. BioDrugs 2004, 18, 63–70.
- Okumura, A.; Ishikawa, T.; Maeno, T.; et al. Changes in natural killer T cells subsets during therapy in type C hepatitis and hepatocellular carcinoma. Hepatol. Res. 2005, 32, 213–217.
- Seymour, J.F.; Estey, E.H.; Keating, M.J.; et al. Response to interferon-alpha in patients with hairy cell leukemia relapsing after treatment with 2-chlorodeoxyadenosine. Leukemia 1995, 9, 929–932.
- Rizza, P.; Moretti, F.; Belardelli, F. Recent advances on the immunomodulatory effects of IFN-alpha: implications for cancer immunotherapy and autoimmunity. Autoimmunity 2010, 43, 204–209.
- Uke, P.; Gorodkin, R.; Beare, N. Biologic therapy for Behçet's uveitis: a systematic review. Br. J. Ophthalmol. 2020, 104, 1045–1051.
- Metzler, C.; Csernok, E.; Gross, W.L.; et al. Interferon-alpha for maintenance of remission in Churg-Strauss syndrome: a long-term observational study. Clin. Exp. Rheumatol. 2010, 28, 24–30.
- Seeliger, B.; Förster, M.; Happe, J.; et al. Interferon-α for induction and maintenance of remission in eosinophilic granulomatosis with polyangiitis: a single-center retrospective observational cohort study. J. Rheumatol. 2017, 44, 806–814.
- Fardeau, C.; Simon, A.; Rodde, B.; et al. Interferon-alpha2a and systemic corticosteroid in monotherapy in chronic uveitis: results of the randomized controlled BIRDFERON study. Am. J. Ophthalmol. 2017, 177, 182–194.
- Brod, S.A.; Atkinson, M.; Lavis, V.R.; et al. Ingested IFN-alpha preserves residual beta cell function in type 1 diabetes. J. Interferon Cytokine Res. 2001, 21, 1021–1030.
- Gigli, G.; Caielli, S.; Cutuli, D.; et al. Innate immunity modulates autoimmunity: type 1 interferon-beta treatment in multiple sclerosis promotes growth and function of regulatory invariant natural killer T cells through dendritic cell maturation. Immunology 2007, 122, 409–417.
- Matsuda, H.; Takeda, K.; Koya, T.; et al. Plasticity of invariant NKT cell regulation of allergic airway disease is dependent on IFN-gamma production. J. Immunol. 2010, 185, 253–262.
- Samileh, N.; Ahmad, S.; Farzaneh, A.; et al. Immunity status in children with Bacille Calmette-Guerin adenitis. A prospective study in Tehran, Iran. Saudi Med. J. 2006, 27, 1719–1724.
- Machold, K.P.; Neumann, K.; Smolen, J.S. Recombinant human interferon gamma in the treatment of rheumatoid arthritis: double blind placebo controlled study. Ann. Rheum. Dis. 1992, 51, 1039–1043.
- Schulof, R.S.; Lloyd, M.J.; Cleary, P.A.; et al. A randomized trial to evaluate the immunorestorative properties of synthetic thymosin-alpha 1 in patients with lung cancer. J. Biol. Response Mod. 1985, 4, 147–158.
- Sugahara, S.; Ichida, T.; Yamagiwa, S.; et al. Thymosin-alpha1 increases intrahepatic NKT cells and CTLs in patients with chronic hepatitis B. Hepatol. Res. 2002, 24, 346–354.
- Dinetz, E.; Lee, E. Comprehensive review of the safety and efficacy of thymosin alpha 1 in human clinical trials. Altern. Ther. Health Med. 2024, 30, 6–12.
- La Cava, A. Low-dose interleukin-2 therapy in systemic lupus erythematosus. Rheumatol. Immunol. Res. 2023, 4, 150–156.
- Su, Q.Y.; Luo, J.; Wang, X.M.; et al. Efficacy, safety and the lymphocyte subsets changes of low-dose IL-2 in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Immun. Inflamm. Dis. 2024, 12, e1165.
- Breban, M.; Dougados, M.; Picard, F.; et al. Intensified-dose (4 gm/m2) cyclophosphamide and granulocyte colony-stimulating factor administration for hematopoietic stem cell mobilization in refractory rheumatoid arthritis. Arthritis Rheum. 1999, 42, 2275–2280.
- Valentine, J.F.; Fedorak, R.N.; Feagan, B.; et al. Steroid-sparing properties of sargramostim in patients with corticosteroid-dependent Crohn's disease: a randomised, double-blind, placebo-controlled, phase 2 study. Gut 2009, 58, 1354–1362.
- Narsai, T.; Su, H.; Braxton, D.; et al. Collagenous gastritis in primary selective IgM deficiency: transition to EBV+ gastric adenocarcinoma. Case Rep. Immunol. 2021, 5574944.
- Ajao, S.O.; Jayasingam, R.; Shaaban, H. Iatrogenic Kaposi's sarcoma unmasked by vedolizumab in a patient with ulcerative colitis and well-controlled human immunodeficiency virus: a case report. Int. J. Crit. Illn Inj. Sci. 2021, 11, 177–180.
- Kurobane, I.; Riches, P.G.; Sheldon, J.; et al. Incidental correction of severe IgA deficiency by displacement bone marrow transplantation. Bone Marrow Transplant. 1991, 7, 494–495.
- Hadžić, N.; Nademi, Z.; Deheragoda, M.; et al. Chronic cholangiopathy associated with primary immune deficiencies can be resolved by effective hematopoietic stem cell transplantation. J. Pediatr. 2019, 209, 97–106.
- Barreto, I.C.D.P.; Barreto, B.A.P.; Cavalcante, E.G.D.N.; et al. Immunological deficiencies: more frequent than they seem to be. J. Pediatr. (Rio J.) 2021, 97, S49–S58.
- Sogkas, G.; Witte, T. The link between rheumatic disorders and inborn errors of immunity. EBioMedicine 2023, 90, 104501.
- García Pavón Osorio, S.; López Tiro, J.J.; Gómez Vera, J. IgE deficiency: a forgotten disease? Rev. Alerg. Mex. 2009, 56, 192–197. (in Spanish)
- Louis, A.G.; Gupta, S. Primary selective IgM deficiency: an ignored immunodeficiency. Clin. Rev. Allergy Immunol. 2014, 46, 104–111.
- Gupta, S.; Gupta, A. Selective IgM deficiency—an underestimated primary immunodeficiency. Front. Immunol. 2017, 8, 1056.
- Vo Ngoc, D.T.; Krist, L.; van Overveld, F.J.; et al. The long and winding road to IgA deficiency: causes and consequences. Expert Rev. Clin. Immunol. 2017, 13, 371–382.
- Stiehm, R.E. The four most common pediatric immunodeficiencies. Adv. Exp. Med. Biol. 2007, 601, 15–26.
- Jamee, M.; Alaei, M.R.; Mesdaghi, M.; et al. The prevalence of selective and partial immunoglobulin A deficiency in patients with autoimmune polyendocrinopathy. Immunol. Invest. 2022, 51, 778–786.
- Mancuso, G.; Bechi Genzano, C.; Fierabracci, A.; et al. Type 1 diabetes and inborn errors of immunity: complete strangers or 2 sides of the same coin? J. Allergy Clin. Immunol. 2023, 151, 1429–1447.
- Grimbacher, B.; Warnatz, K.; Yong, P.F.K.; et al. The crossroads of autoimmunity and immunodeficiency: lessons from polygenic traits and monogenic defects. J. Allergy Clin. Immunol. 2016, 137, 3–17.
- Khalaf, L.; Hamdan, M.; Lahlouh, M.; et al. Overlapping autoimmunity and immunodeficiency: a case of selective IgA deficiency with autoimmune hemolytic anemia. BMC Pediatr. 2026, 26, 153.
- Schmidt, R.E.; Grimbacher, B.; Witte, T. Autoimmunity and primary immunodeficiency: two sides of the same coin? Nat. Rev. Rheumatol. 2018, 14, 7–18.
- Walter, J.E.; Ayala, I.A.; Milojevic, D. Autoimmunity as a continuum in primary immunodeficiency. Curr. Opin. Pediatr. 2019, 31, 851–862.
- Taietti, I.; Votto, M.; De Filippo, M.; et al. Selective IgM deficiency: evidence, controversies, and gaps. Diagnostics 2023, 13, 2861.
- Akalu, Y.T.; Bogunovic, D. Inborn errors of immunity: an expanding universe of disease and genetic architecture. Nat. Rev. Genet. 2024, 25, 184–195.
- Tiong, B.K.; Dahhan, T. Selective immunoglobulin E deficiency: an overlooked hypogammaglobulinemia and its association with rheumatoid arthritis. Curr. Opin. Rheumatol. 2026, in press. DOI: https://doi.org/10.1097/BOR.0000000000001150
- Ward, A.C. The interleukin-7 receptor signaling pathway and its perturbation in immunodeficiency, autoimmune disease and lymphoid malignancy. Biomolecules 2026, 16, 219.
- Sağun, F.; Çölkesen, F.; Gerek, M.E.; et al. Autoimmune cytopenias in inborn errors of immunity: associations with monogenic mutations and immunologic parameters. BMC Immunol. 2025, 26, 66.
- Ben Abdelaziz, A.; Zanina, Y.; Bradai, S.; et al. Bibliometrics of scientific biomedical publications on primary immunodeficiency diseases in the Arab world (2020–2024). Tunis Med. 2025, 103, 990–1000.
- Rodríguez-Ubreva, J.; Calvillo, C.L.; Forbes Satter, L.R.; et al. Interplay between epigenetic and genetic alterations in inborn errors of immunity. Trends Immunol. 2023, 44, 902–916.
- Xiao, Z.; He, R.; Zhao, Z.; et al. Dysregulation of epigenetic modifications in inborn errors of immunity. Epigenomics 2024, 16, 1301–1313.
- Ashkanani, G.; Rob, M.; Yousef, M.; et al. The effects of microbiome modulating therapies on inflammatory markers in autoimmune disease: a systematic review and meta-analysis. Nutrients 2026, 18, 560.
- Torrance, R.; Orf, K.; Fox, T.A. Gene therapy for inborn errors of immunity: past progress, current status and future directions. Rare Dis. Orphan Drug J. 2025, 4, 29.
- Graafen, L.; Speckmann, C.; Bakhtiar, S.; et al. Syndromic inborn errors of immunity in TREC-newborn screening: 5-year experience from the German screening program. J. Clin. Immunol. 2026, 46, 35. DOI: https://doi.org/10.1007/s10875-026-01995-2
- Gaál, Z.; Meehan, C.; Yilmaz, M.; et al. Investigating biomarkers for inborn errors of immunity in a prospective study of patients with autoimmune cytopenia. Pediatr. Blood Cancer 2026, 73, e70074.
- Rivière, J.G.; Pasquet, M.; Gambineri, E. Building alliances for early detection of immunodeficiencies: from primary care to hematology. Front. Immunol. 2026, 16, 1701384.
- Bellanti, J.A.; Settipane, R.A. Essentials of an immunodeficiency primer: a practical reference for the allergist/immunologist and the allergy-immunology fellow-in-training (FIT). Allergy Asthma Proc. 2024, 45, 291–293.
- Zheng, S.; Lowe, D.M. Current infectious disease management challenges in inborn errors of immunity. Ann. Clin. Microbiol. Antimicrob. 2025, 24, 60.
- Zygadło, J.; Cieślik, M.; Dumycz, K.; et al. Efficacy and safety of bacterial immunostimulants in immunodeficient individuals: a systematic review and meta-analysis. Pediatr. Allergy Immunol. 2026, 37, e70276.
- Zygadło, J.; Procyk, G.; Balsam, P.; et al. Autoantibodies in atrial fibrillation—state of the art. Int. J. Mol. Sci. 2023, 24, 1852.
- Yilmaz, D.; Soyoz, M.; Sahin, A.; et al. Association between mannose binding lectin gene polymorphisms and clinical severity of COVID-19 in children. Mol. Biol. Rep. 2023, 50, 5871–5877.
- Abdalgani, M.; Hernandez, E.R.; Pedroza, L.A.; et al. Clinical, immunologic and genetic characteristics of 148 patients with NK cell deficiency. J. Allergy Clin. Immunol. 2025, 155, 1623–1634.
- Mousavi, S.; Hosseini, M.H.; Sarandili, S.; et al. Myeloperoxidase deficiency: a rare case. Cureus 2024, 16, e63596.
- Kolak, S.; Çölkesen, F.; Gerek, M.E.; et al. Comparison of clinical characteristics in primary immunodeficiency patients based on the presence of autoimmunity or autoinflammation. Allergy Asthma Proc. 2026, 47, 149–156.

Download
