Abstract:
Infectious susceptibility is a component of many inborn errors of immunity. Nevertheless, antibiotic use is often used as a surrogate in history taking for infectious susceptibility, thereby disadvantaging patients who present with viral infections as their phenotype. Further complicating clinical evaluations are unusual manifestations of viral infections which may be less familiar that the typical respiratory viral infections. This review covers several unusual viral phenotypes arising in patients with inborn errors of immunity and other settings of immune compromise. In some cases, chronic infections lead to oncogenesis or tumor-like growths and the conditions and mechanisms of viral-induced oncogenesis will be described. This review covers enterovirus, rubella, measles, papillomavirus, and parvovirus B19. It does not cover EBV and hemophagocytic lymphohistiocytosis nor lymphomagenesis related to EBV. EBV susceptibility has been recently reviewed. Our goal is to increase awareness of the unusual manifestations of viral infections in patients with IEI and to describe treatment modalities utilized in this setting. Coincidentally, each of the discussed viral infections can have a cutaneous component and figures will serve as a reminder of the physical features of these viruses. Given the high morbidity and mortality, early recognition can only improve outcomes.
摘要:
感染易感性是许多先天免疫错误的组成部分。然而,抗生素的使用通常被用作历史上的替代品,以治疗感染易感性,从而不利于以病毒感染为表型的患者。进一步复杂的临床评估是病毒感染的不寻常表现,其可能比典型的呼吸道病毒感染更不熟悉。这篇综述涵盖了先天性免疫错误和其他免疫受损情况下出现的几种不寻常的病毒表型。在某些情况下,慢性感染导致肿瘤发生或肿瘤样生长,病毒诱导肿瘤发生的条件和机制将被描述。这篇综述涵盖了肠道病毒,风疹,麻疹,乳头瘤病毒,和细小病毒B19.它不包括EBV和噬血细胞淋巴组织细胞增生症,也不包括与EBV相关的淋巴形成。最近对EBV易感性进行了综述。我们的目标是提高对IEI患者病毒感染异常表现的认识,并描述在这种情况下使用的治疗方式。巧合的是,所讨论的每种病毒感染都可以具有皮肤成分,并且数字将提醒人们这些病毒的物理特征。鉴于发病率和死亡率高,早期识别只能改善结果。