Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency
Abstract
:1. Introduction
2. Experimental Section
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Primary Hypogammaglobulinemia (1) | Secondary Hypogammaglobulinemia (2) | p - Value | |
---|---|---|---|
Number (n) | 38 | 38 | |
Male Gender (n (%)) | 13 (34.21) | 10 (26.32) | ns |
Current Age (Mean (IQR)) | 51.82 y (37.5–60) | 57.66 y (52–66.25) | ns |
Age at Diagnosis of Hypogammaglobulinemia (Mean (IQR)) | 38.5 y (24.75–53.75) | 53.42 y (47.5–61.25) | *** (<0.0001) |
Patients Treated with Immunoglobulin Replacement (n (%)) | 37 (97.37) | 7 (18.42) | *** (<0.0001) |
IgG (Mean (IQR)) | 2.74 g/L (0.71–4.6) | 5.63 g/L (4.99–6.22) | *** (<0.0001) |
IgA (Mean (IQR)) | 0.45 g/L (0.04–0.48) | 1.45 g/L (0.77–1.97) | *** (<0.0001) |
IgM (Mean (IQR)) | 0.69 g/L (0.18–0.96) | 0.83 g/L (0.52–1.05) | *** (0.0003) |
Absolute Lymphocyte Count (Mean (IQR)) | 1653 (1019–2080) | 1469 (1011–1838) | ns |
Lymphocyte Percentage (Mean (IQR)) | 22.82 (16.75–28.25) | 20.92 (13–27) | ns |
Pat. Nr. | Rheumatic Disease | Current Therapy | Therapy at Diagnosis of Hypogammaglobulinemia | Previous Therapies |
---|---|---|---|---|
1 | perSpA | MTX | MTX | |
2 | RA | MTX | MTX | |
3 | axSpA | adalimumab | MTX | MTX, SSZ |
4 | AOSD | prednisolone | prednisolone | |
5 | SSc | MTX | MTX | |
6 | perSpA | MTX + etanercept | MTX + SSZ | MTX, SSZ, LFN |
7 | SLE | MMF | CYC | CYC, HCQ |
8 | SLE | MTX | MTX | HCQ |
9 | SLE | MMF | MMF | |
10 | RA | MTX | MTX | HCQ, SSZ |
11 | SLE | CYC | CYC | AZA, MMF, HCQ |
12 | SLE | CYC | CYC | AZA, MMF, HCQ |
13 | RA | TCZ | MTX + RTX | MTX, LFN, SSZ, gold, adalimumab, infliximab |
14 | RA | MTX | MTX | |
15 | GCA | MTX | MTX | |
16 | RA | MTX + etanercept | MTX | MTX, HCQ |
17 | SLE | LFN + HCQ | MTX + HCQ | AZA, MTX, HCQ |
18 | axSpA | MTX + infliximab | MTX + infliximab | adalimumab |
19 | SS | prednisolone | prednisolone | |
20 | RA | MTX | MTX | |
21 | SS | MMF | MMF | CYC, AZA |
22 | PG | prednisolone | prednisolone | |
23 | AOSD | prednisolone | prednisolone | |
24 | SS | MTX | MTX | |
25 | SLE | MMF + HCQ | MMF | MMF |
26 | GCA | MTX | MTX | |
27 | SS | MTX | MTX | |
28 | SLE | AZA + HCQ | AZA + HCQ | MTX |
29 | RA | MTX | MTX | |
30 | RA | MTX | MTX | |
31 | RA | TCZ | SSZ + MTX | MTX, SSZ, LFN, adalimumab, abatacept |
32 | perSpA | adalimumab | SSZ + MTX | SSZ, MTX, HCQ |
33 | SLE | AZA | AZA | HCQ |
34 | SS | AZA + HCQ | AZA + HCQ | |
35 | SS | AZA | AZA | |
36 | SLE | MMF | MMF | HCQ |
37 | RA | MTX + RTX | MTX + RTX | LFN, MTX, HCQ, SSZ |
38 | RA | MTX + adalimumab | MTX + RTX | TCZ, etanercept, abatacept, SSZ, LFN, HCQ, MTX |
Proposed Diagnostic Criterion | I. Naive B Cells >80 (%B Cells) | II. cl. sw. Memory B Cells <2.2 (%B Cells) | III. CD21low CD38low B Cells >10 (%B Cells) | IV. Memory CD4+ T Cells >70 (%CD4+ T Cells) | V. CD4+ T Follicular Cells >20 (%CD4+ T Cells) | VI. At Least One of Criteria II. or V |
---|---|---|---|---|---|---|
Sensitivity (%) | 52.63 | 63.16 | 31.58 | 39.47 | 47.37 | 76.32 |
95% c.i. | 35.82–69.02 | 45.99–78.19 | 17.5–48.65 | 24.04–56.61 | 30.98–64.18 | 59.76–88.56 |
Specificity (%) | 86.49 | 94.59 | 94.59 | 92.11 | 100 | 94.74 |
95% c.i. | 71.23–95.46 | 81.81–99.34 | 81.81–99.34 | 78.62–98.34 | 90.75–100.0 | 88.25–99.36 |
PPV | 80 | 92.31 | 85.71 | 83.33 | 100 | 93.55 |
95% c.i. | 59.3–93.17 | 74.87–99.05 | 57.19–98.22 | 58.58–96.42 | 81.47–100.0 | 78.58–99.21 |
NPV | 64 | 71.43 | 57.38 | 60.34 | 65.52 | 80 |
95% c.i. | 49.19–77.08 | 56.74–83.42 | 44.06–69.96 | 46.64–72.95 | 51.88–77.51 | 65.4–90.42 |
p - value | 0.0005 | <0.0001 | 0.0062 | 0.0024 | <0.0001 | <0.0001 |
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Jablonka, A.; Etemadi, H.; Adriawan, I.R.; Ernst, D.; Jacobs, R.; Buyny, S.; Witte, T.; Schmidt, R.E.; Atschekzei, F.; Sogkas, G. Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency. J. Clin. Med. 2020, 9, 1049. https://doi.org/10.3390/jcm9041049
Jablonka A, Etemadi H, Adriawan IR, Ernst D, Jacobs R, Buyny S, Witte T, Schmidt RE, Atschekzei F, Sogkas G. Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency. Journal of Clinical Medicine. 2020; 9(4):1049. https://doi.org/10.3390/jcm9041049
Chicago/Turabian StyleJablonka, Alexandra, Haress Etemadi, Ignatius Ryan Adriawan, Diana Ernst, Roland Jacobs, Sabine Buyny, Torsten Witte, Reinhold Ernst Schmidt, Faranaz Atschekzei, and Georgios Sogkas. 2020. "Peripheral Blood Lymphocyte Phenotype Differentiates Secondary Antibody Deficiency in Rheumatic Disease from Primary Antibody Deficiency" Journal of Clinical Medicine 9, no. 4: 1049. https://doi.org/10.3390/jcm9041049