{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:40:06Z","timestamp":1791333606207,"version":"4.3.1"},"reference-count":15,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Autoimmune-Poly-Endocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED), caused by mutations in the Autoimmune Regulator (AIRE) gene, is an autosomal recessive multi-organ autoimmunity syndrome usually defined by high serum titers of type I Interferon Autoantibodies (Type 1 IFN-Abs). These antibodies have recently been found in individuals in the general population who develop life-threatening Coronavirus Disease 2019 (COVID-19), but the significance of pre-existing Type 1 IFN-Abs in APECED patients with COVID-19 remains unclear. Previous reports of COVID-19 outcomes in APECED patients have been divergent, and protective roles have been proposed for female sex, age &lt;26 years, and immunomodulatory medications including intravenous immunoglobulin (IVIg). We report the case of a 30-year-old male APECED patient who experienced a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection with mild symptoms of fatigue and headache without respiratory distress and did not require hospitalization. He received a stress dose of hydrocortisone for adrenal insufficiency and continued on his baseline medications, including subcutaneous administration of Immunoglobulins (SCIgs) for chronic inflammatory demyelinating polyneuropathy (CIDP). Mild COVID-19 in a 30-year-old male patient with APECED and pre-existing Type 1 IFN-Abs was unexpected. Younger age and management of autoimmunity may have played a role.<\/jats:p>","DOI":"10.3390\/pathogens12030403","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T03:06:43Z","timestamp":1677726403000},"page":"403","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Mild COVID-19 in an APECED Patient with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and High Titer of Type 1 IFN-Abs: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"given":"Mariella","family":"Valenzise","sequence":"first","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Foti Randazzese","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Toscano","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortunato","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Salzano","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Pajno","sequence":"additional","affiliation":[{"name":"Department Maternal and Child Health, Urological Sciences-Sapienza University, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata","family":"Wasniewska","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-1796","authenticated-orcid":false,"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy"},{"name":"Infectious and Tropical Diseases Unit, AOU Policlinico \u201cP. Giaccone\u201d, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen A","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, Molecular Genetics University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1007\/s40618-021-01585-6","article-title":"Autoimmune polyendocrine syndrome type 1: An Italian survey on 158 patients","volume":"44","author":"Garelli","year":"2021","journal-title":"J. Endocrinol. Investig."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13052-017-0331-6","article-title":"Novel insight into Chronic Inflammatory Demyelinating Polineuropathy in APECED syndrome: Molecular mechanisms and clinical implications in children","volume":"43","author":"Valenzise","year":"2017","journal-title":"Ital. J. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6515","DOI":"10.1126\/science.abd4585","article-title":"Autoantibodies against type I IFNs in patients with life-threatening COVID-19","volume":"370","author":"Bastard","year":"2020","journal-title":"Science"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e20210554","DOI":"10.1084\/jem.20210554","article-title":"Preexisting autoantibodies to type I IFNs underlie critical COVID-19 pneumonia in patients with APS-1","volume":"218","author":"Bastard","year":"2021","journal-title":"J. Exp. 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