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HEMOLYTIC ANEMIA

 
  Hemolytic Anemia

 

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Autoimmune Lymphoproliferative Syndrome

 

Autoimmune Lymphoproliferative Syndrome (ALPS) - This disease is characterized by defective activation induced cell death which leads to uncontrolled lymphoproliferation.  Patients develop hepatosplenomegaly, adenopathy, and autoimmune cytopenias (autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, autoimmune neutropenia).  

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CVID

 

CVID - Approximately 25% of patients develop autoimmune disease.  Autoimmune hemolytic anemia and ITP are the most frequently reported conditions.  

 

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AID Deficiency

 

AID deficiency - Patients develop autoimmune manifestations at high frequency (approximately 25%).  These include hemolytic anemia, thrombocytopenia, and autoimmune hepatitis. 
  

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IgA Deficiency

 

IgA deficiency - Patients have an increased incidence of autoimmune disease including juvenile idiopathic arthritis, SLE, vitiligo, hemolytic anemia, ITP, and thyroiditis.  Most patients with IgA deficiency do not have recurrent infections.
  

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IPEX

 

IPEX - Approximately one-half of patients with this syndrome develop autoimmune cytopenias including coombs positive hemolytic anemia, ITP, and autoimmune neutropenia.  

 

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Wiskott-Aldrich Syndrome

 

Wiskott-Aldrich syndrome - Autoimmune disorders have been reported in 40% of patients.  These include hemolytic anemia, autoimmune neutropenia, skin and cerebral vasculitis, arthritis, renal disease, and Henoch-Schonlein purpura. 

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MHC Class II Deficiency

 

MHC Class II Deficiency - Autoimmune cytopenias (hemolytic anemia, neutropenia) have been described in 10% of patients. 

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PNP Deficiency

 

Purine Nucleoside Phosphorylase (PNP) deficiency - Patients develop a number of autoimmune manifestations including hemolytic anemia, ITP, and autoimmune neutropenia.  Less common manifestations include SLE and CNS vasculitis.  

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Kabuki Syndrome

 

Kabuki syndrome - Autoimmune hemolytic anemia and ITP have been reported in this disease. 

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Cartilage Hair Hypoplasia

 

Cartilage Hair Hypoplasia - Patients can develop autoimmune manifestations such as hemolytic anemia, ITP, juvenile idiopathic arthritis, and autoimmune enteropathy. 

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Cernunnos Deficiency

 

Cernunnos deficiency - Two patients with autoimmune hemolytic anemia and ITP have been reported.  

 

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G6PD Deficiency

 

Glucose-6-phosphate-dehydrogenase (G-6PD) deficiency - Patients develop hemolytic anemia.  Decreased G-6PD function leads to a reduction in NADPH (which protects erythrocytes from oxidative stress).  If the G-6PD activity is below 5%, the oxidative burst of phagocytes is also severely impaired (NBT test and dihydrodhodamine assay will be abnormal) and patients develop CGD-like infections. 

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CTLA4 Deficiency

 

CTLA4 Deficiency - patients develop multi-organ autoimmune manifestations including inflammatory bowel disease,autoimmune cytopenia, psoriasis, and thyroid disease. Patients also develop splenomegaly, hepatomegaly, bronchiectasis, GLILD, and generalized lymphadenopathy.

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LRBA Deficiency

 

LRBA Deficiency - patients develop multi-organ autoimmune manifestations including inflammatory bowel disease,autoimmune cytopenia, psoriasis, and thyroid disease. Patients also develop splenomegaly, hepatomegaly, bronchiectasis, GLILD, and generalized lymphadenopathy.

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PIK3CD Gain of Function

 

PIK3CD Gain of Function - patients develop autoimmune manifestations including inflammatory bowel disease, autoimmune cytopenia, and autoimmune primary sclerosing cholangitis. Patients may also develop EBV/CMV induced lymphoproliferation, hepatosplenomegaly and malignancy (lymphoma).

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STAT3 Gain of Function

 

STAT3 Gain of Function - patients develop multi-organ autoimmune manifestations including autoimmune enteropathy autoimmune cytopenia, type I diabetes, and interstitial lung disease.

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