تقرير
Prolonged Disease Course of COVID-19 in a Patient with CTLA-4 Haploinsufficiency.
| العنوان: | Prolonged Disease Course of COVID-19 in a Patient with CTLA-4 Haploinsufficiency. |
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| المؤلفون: | Hoffman TW; Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, Netherlands., Leavis HL; Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands., Smits BM; Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands., van der Veken LT; Department of Genetics, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands., van Kessel DA; Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, Netherlands.; Department of Pulmonology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands. |
| المصدر: | Case reports in immunology [Case Reports Immunol] 2023 May 22; Vol. 2023, pp. 3977739. Date of Electronic Publication: 2023 May 22 (Print Publication: 2023). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Hindawi Publishing Corporation Country of Publication: Egypt NLM ID: 101622188 Publication Model: eCollection Cited Medium: Print ISSN: 2090-6609 (Print) Linking ISSN: 20906617 NLM ISO Abbreviation: Case Reports Immunol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2011]- |
| مستخلص: | Patients with primary immunodeficiencies are especially vulnerable to developing severe coronavirus disease 2019 (COVID-19) after infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cytotoxic T lymphocyte antigen-4 (CTLA-4) is an important regulator of immune responses, and patients who suffer from CTLA4 haploinsufficiency have hyperactivation of effector T cells and infiltration of various organs. Overexpression of CTLA4 has been associated with a more severe disease course in patients with COVID-19, but there have only been a few reports on the disease course of COVID-19 in patients with CTLA4 haploinsufficiency. We report on a 33-year-old female with a history of immune thrombocytopenia, autoimmune haemolytic anaemia, granulomatous-lymphocytic interstitial lung disease, and common variable immunodeficiency who developed COVID-19. She was admitted and discharged from the hospital several times in the months thereafter and remained symptomatic and had a positive SARS-CoV-2 PCR for up to 137 days after the first symptoms. No SARS-CoV-2 antibodies were identified in the patients' serum. The disease was finally controlled after repeated infusions of convalescent plasma and treatment of concurrent bacterial and fungal infections. Genetic analysis revealed a likely pathogenic variant in CTLA4 , and CTLA4 expression on regulatory T-cells was low. This case illustrates that patients with primary immunodeficiencies who have a protracted disease course of COVID-19 could benefit from convalescent plasma therapy. Competing Interests: The authors declare that there are no conflicts of interest. (Copyright © 2023 T. W. Hoffman et al.) |
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| تواريخ الأحداث: | Date Created: 20230601 Latest Revision: 20230604 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10228224 |
| DOI: | 10.1155/2023/3977739 |
| PMID: | 37260564 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2090-6609 |
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| DOI: | 10.1155/2023/3977739 |