Inborn Errors of Immunity among Children with Recurrent Acute Otitis Media

Background Recurrent acute otitis media (rAOM) is one of the warning signs for inborn errors of immunity (IEIs), but data are limited on IEIs among children with rAOM, particularly in developing countries.

Methods A cross-sectional study was conducted between 2019 and 2020 at an

Egyptian medical centre and included children with rAOM aged from 6 months to 16 years. Those with structural or functional abnormalities predisposing to rAOM were excluded. Enrolled children underwent thorough clinical assessment, ENT examination, and immunological investigations, including haematological counting, quantitative immunoglobulins assay, lymphocytic flow cytometric immunophenotyping, CH50, and phagocytic function tests.

Results The study included 69 children with rAOM (44 boys and 25 girls) with a median age of 30 months. IEIs were identified in 14 (20%) children, and included transient hypogammaglobulinemia, selective IgA deficiency, agammaglobulinemia, common variable immunodeficiency, congenital neutropenia, Chediak Higashi syndrome, Hyper IgM syndrome, and Griscelli syndrome. Parental consanguinity and history of unexplained/infection-related siblings’ deaths were significantly associated with IEIs (p 0.018 and 0.003, respectively). IEIs cases had significantly higher number of AOM in the last year (6 [4 – 8] vs 5 [3 – 8]; p 0.018) and lower levels of hemoglobin (10.7 ±2.80 vs 12.3 ± 1.64 g/dl; p 0.002) and IgG (393.5 [78 – 1370] vs. 708 [42.3 – 1509]; p 0.000) compared with non-IEIs cases.

Conclusion The current study identified IEIs in one-fifth of children with rAOM, and most are predominately antibody deficiencies, demanding higher awareness among pediatricians and otorhinolaryngologists for timely diagnosis that is essential for optimal outcome.

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Artikel online veröffentlicht:
24. Mai 2022