{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T10:50:59Z","timestamp":1750762259165,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Polyautoimmunity or multiple autoimmune syndrome (MAIS) is increasingly being recognized in pediatric clinical practice, often in conjunction with systemic lupus erythematosus (SLE). Besides multi\u2010organ autoimmunity, children with SLE are often at a higher risk of developing infections including tuberculosis. The tendency to develop infections and multiple autoimmune diseases in childhood SLE often occurs in the absence of monogenic primary immunodeficiency disease. Conversely, children with inborn errors of immunity, of which selective IgA deficiency (sIgAD) is the most common, may develop recurrent infections and autoimmune disorders including SLE. Herein, we report a child with MAIS (including SLE) and sIgAD who developed drug\u2010resistant tuberculosis, which was managed successfully with second\u2010line anti\u2010tubercular drug therapy. To the best of our knowledge, this combination of rare findings has not been reported previously in the pediatric literature. Although a majority of patients with sIgAD are either asymptomatic or have mild infections\/autoimmunity, the index child had a myriad of infectious illnesses and multi\u2010organ autoimmunity. Our case highlights the prudence of thoroughly evaluating children with SLE for other autoimmune diseases and vice versa. Given the higher probability of inherited disorders, including early complement deficiencies and monogenic interferonopathies, in childhood SLE compared with adult SLE, it may be prudent to perform a basic immunological workup (for example, immunoglobulin levels, 50% hemolytic complement) in such patients. A more extensive immunological and genetic evaluation (including next\u2010generation sequencing) may also be required in the presence of unusual clinical or laboratory features, a positive family history, or a complicated clinical course.<\/jats:p>","DOI":"10.1111\/1756-185x.14289","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T09:37:32Z","timestamp":1642671452000},"page":"367-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Disseminated drug\u2010resistant tuberculosis and multiple autoimmune syndrome in a child with selective IgA deficiency\u2014An uncustomary combination"],"prefix":"10.1111","volume":"25","author":[{"given":"Harshita","family":"Nori","sequence":"first","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viresh","family":"Vohra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5486-4267","authenticated-orcid":false,"given":"Aaqib Zaffar","family":"Banday","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-0661","authenticated-orcid":false,"given":"Ankur Kumar","family":"Jindal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reva","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandeep Kaur","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Government Medical College &amp; Hospital  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanjit","family":"Bal","sequence":"additional","affiliation":[{"name":"Department of Histopathology Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepti","family":"Suri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Allergy Immunology Unit Advanced Pediatrics Centre Postgraduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311412096"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.049"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-019-08756-7"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13454"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.062984"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-012-8317-z"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2018.03.009"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2018.11.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203310374486"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000493"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbr.2014.04.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-014-0302-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307077543"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39110"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCD.0b013e3283414db7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-011-2063-y"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.14289","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185X.14289","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.14289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T14:30:47Z","timestamp":1693146647000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.14289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,20]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/1756-185X.14289"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.14289","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"type":"print","value":"1756-1841"},{"type":"electronic","value":"1756-185X"}],"subject":[],"published":{"date-parts":[[2022,1,20]]},"assertion":[{"value":"2021-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}