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CTLA-4 haploinsufficiency is an inborn error of immunity caused by loss of function in one copy of the CTLA-4 gene, leading to reduced expression and/or function of the CTLA-4 protein. This results in immune dysregulation and immunodeficiency. In addition to increased susceptibility to infections, patients may present with autoimmunity, lymphoproliferation, and gastrointestinal, respiratory, and neurologic complaints. We report a case of CTLA-4 haploinsufficiency with good response to abatacept.

Intradermal allergy skin tests (SKT) use stainless steel hypodermic needles to deliver allergens. Hypersensitivity reactions to these needles are rare. We report a case of a delayed hypersensitivity reaction to the metallic components of type 304 stainless steel hypodermic needles.

X-linked inhibitor of apoptosis deficiency (XIAP) is a rare inborn error of immunity caused by loss of function mutations in the XIAP gene. XIAP encodes an apoptosis inhibitor protein which plays a crucial role in innate and adaptive immune responses. The disease is characterized by immune dysregulation, increased risk of hemophagocytic lymphohistiocytosis, dysgammaglobulinemia, increased susceptibility to infections, inflammatory bowel disease (IBD), and autoinflammatory conditions.

Acrylates are synthetic thermoplastic resins used in a multitude of products such as plastics, adhesives, and sealants/coatings. We report an unusual and severe case of acrylate-induced contact dermatitis localized to the left side of the patient's face and neck.

Hereditary alpha tryptasemia (HaT) is an autosomal dominant genetic trait characterized by elevated basal serum tryptase levels due to extra allelic copies of the tryptase alpha/beta 1 (TPSAB1) gene. HaT has been associated with multisystem complaints and as a modifier of mast cell-associated disorders and anaphylaxis.

Polymyalgia rheumatica (PMR) is an inflammatory disorder characterized by muscle pain and stiffness. We present a 67-year-old man who developed PMR after immunization with the mRNA COVID-19 vaccine.

Type I hereditary angioedema (HAE) is characterized by recurrent episodes of swelling of the skin, gastrointestinal tract, and upper airway. Here we present a child with chronic abdominal pain who was found to have a novel deleterious variant in the serine protease inhibitor 1 (SERPING1) gene resulting in autosomal dominant (AD) HAE.