1. Inborn Errors of Immunity—the Sri Lankan Experience 2010–2022.
- Author
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Dasanayake, Dhanushka, Bustamante, Jacinta, Boisson–Dupuis, Stéphanie, Karunatilleke, Chandima, Thambyrajah, James, Puel, Anne, Chan, Koon Wing, Doffinger, Rainer, Lau, Yu-Lung, Casanova, Jean-Laurent, Kumararatne, Dinakantha, and de Silva, Rajiva
- Subjects
CHRONIC granulomatous disease ,SEVERE combined immunodeficiency ,IMMUNITY ,MEDICAL research ,NUCLEOTIDE sequencing ,AGAMMAGLOBULINEMIA - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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