Background Inborn errors of immunity are rare, genetically heterogeneous disorders requiring coordinated clinical, laboratory, and genetic evaluation over time. Data are often fragmented across records, laboratory systems, and genomic reports, limiting longitudinal analysis and coordinated care, particularly in the Middle East and North Africa, where structured rare disease data infrastructures remain limited. Objective To develop a Research Electronic Data Capture–based data management framework for inborn errors of immunity and demonstrate its use in a prospective multi-site setting. Methods A Research Electronic Data Capture–based framework was developed at the College of Medicine and Health Sciences, United Arab Emirates University. Modular instruments captured consent, demographics, biospecimen processing, laboratory workflows, and genetic findings within a longitudinal structure. Data dictionaries, validation rules, and conditional logic ensured data quality. The framework was deployed across participating sites for prospective data collection. Results The framework enabled integrated longitudinal documentation of enrollment, biospecimens, and genetic testing. It was implemented across two clinical sites and used to enroll patients with suspected or confirmed inborn errors of immunity. The platform supported standardized cross-site data capture and monitoring of genetic findings, including automated flagging of variants of uncertain significance. Conclusion This study demonstrates the development and early multi-site implementation of a Research Electronic Data Capture–based framework for inborn errors of immunity. By enabling standardized integration of clinical, laboratory, and genetic data, the platform supports data quality, cross-site collaboration, and tracking of evolving diagnoses. It provides a scalable foundation for rare disease research and may support improved clinical decision-making.
M. Ahmed, A. A. Bousfiha, F. Almarzooqi· Frontiers in Immunology· 0 citations
Fulminant viral hepatitis (FVH) in children is a rare but often fatal form of acute liver failure occurring in the absence of preexisting liver disease. Its exceptional incidence during otherwise common viral infections, including hepatitis A virus (HAV), hepatitis B virus (HBV), and herpes simplex virus (HSV), supports a decisive role for host susceptibility. Recent advances in human immunogenetics delineate two major, mechanistically distinct pathways to pediatric FVH. The first reflects failure of immune regulation, culminating in excessive IFN-γ–driven inflammation and immune-mediated hepatocellular necrosis. Autosomal recessive IL-18BP and IL-10RB deficiencies exemplify this mechanism, in which disruption of key regulatory checkpoints permits uncontrolled activation of cytotoxic lymphocytes and macrophage-dependent immunopathology, particularly in the context of HAV infection. The second pathway involves impaired intrinsic antiviral defense, most prominently through neutralizing autoantibodies against type I interferons, which phenocopy genetic defects of IFN-I signaling and are strongly associated with HSV-triggered FVH; in this setting, inadequate early antiviral control enables unchecked hepatic replication with extensive cytopathic damage. Finally, syndromic hyperinflammatory disorders, including familial hemophagocytic lymphohistiocytosis and X-linked lymphoproliferative disease, broaden the spectrum of immune predisposition in which fulminant hepatitis may arise. Together, these discoveries redefine pediatric FVH as an immunopathological syndrome and provide a framework for targeted genetic and serologic diagnosis and for mechanism-based interventions aimed at improving survival.
M. Bousfiha, Dalal Ben Sabbahia, E. Jouanguy et al.· Frontiers in Immunology· 0 citations
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