Amanpreet Kalkat

University Hospitals of Cleveland

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Robert Hostoffer

University Hospitals of Cleveland

Olivia Humpel

Lake Erie College of Osteopathic Medicine

Ashwin Shankar

University Hospitals of Cleveland

Meghan Callahan

Lake Erie College of Osteopathic Medicine

Nicholas Hartog

Michigan State University

Nicholas Brodszki

Skåne University Hospital

Mahnaz Jamee

Shahid Beheshti University of Medical Sciences

Claudio Pignata

Federico II University Hospital

Peter Mustillo

Nationwide Children's Hospital

Roberta Caorsi

Istituto Giannina Gaslini

Cooperative Institutions

Cincinnati Children's Hospital Medical Center

University of Cincinnati

University Hospitals of Cleveland

National Institutes of Health

University of Cincinnati Medical Center

National Institute of Allergy and Infectious Diseases

Immune Deficiency Foundation

Istituti di Ricovero e Cura a Carattere Scientifico

Universidade de São Paulo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

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LATE-ONSET GAMMA INTERFERON RECEPTOR-1 DEFICIENCY WITH NONTUBERCULOUS MYCOBACTERIAL INFECTION

Annals of Allergy Asthma & Immunology (2023)

Olivia Humpel Anuraj H. Shankar L. Nagireddi Amanpreet Kalkat Robert Hostoffer

Nontuberculous Mycobacteria

Mycobacterium avium complex

10.1016/j.anai.2023.08.419

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A coronavirus disease 2019–vaccinated patient with phosphoinositide 3-kinase disease with mild illness after severe acute respiratory syndrome coronavirus 2 infection

Annals of Allergy Asthma & Immunology (2022)

Sandeep Sarkaria Amanpreet Kalkat Robert Hostoffer

Coronavirus

Respiratory illness

Betacoronavirus

2019-20 coronavirus outbreak

10.1016/j.anai.2022.02.004

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Novel BTK Mutation in Patient with Late Diagnosis of X-Linked Agammaglobulinemia

Case Reports in Immunology (2023)

Amanpreet Kalkat Olivia Humpel Robert Hostoffer

X-linked agammaglobulinemia (XLA) is a genetic disorder with mutation in Bruton's tyrosine kinase (BTK). Defects in B cell development and immunoglobulin production lead to recurrent infections following loss of maternal IgG at 6 months of age. A 55-year-old male with a longstanding common variable immunodeficiency diagnosis on infusion therapy presented to the clinic with cutaneous T-cell lymphoma, which inspired overall repeat evaluation. Immunoglobulin levels and lymphocyte markers, family history, and genetic testing prompted a true diagnosis of XLA and novel mutation in the BTK gene. Disease-associated mutations have been noted in all five domains of BTK, with missense variants most commonly cited among the 100s of reported genetic alterations. The BTK protein is expressed in hematopoietic lineages and plasma cells, with the exception of T lymphocytes. Disruption in the protein function or absence of BTK halts normal B cell development at the pre-B transitional cell stage and induces premature apoptosis. We present the first reported case of a novel hemizygous BTK c.1492C > G mutation in a patient causing XLA.

X-linked agammaglobulinemia

10.1155/2023/6698913

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NOVEL MUTATION IN BRUTON'S TYROSINE KINASE IN PATIENT WITH CUTANEOUS T CELL LYMPHOMA

Annals of Allergy Asthma & Immunology (2023)

Olivia Humpel Amanpreet Kalkat Robert Hostoffer

X-linked agammaglobulinemia

Common Variable Immunodeficiency

Hypogammaglobulinemia

10.1016/j.anai.2023.08.424

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Rapid desensitization to elexacaftor/tezacaftor/ivacaftor in a cystic fibrosis patient using fatty snack for improved absorption

Pediatric Pulmonology (2023)

Irfan Ali Amanpreet Kalkat Robert Hostoffer

The authors declare no conflicts of interest. Data sharing is not applicable to this article as no data sets were generated or analyzed.

Ivacaftor

10.1002/ppul.26609

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COVID-19 Vaccination in Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: a USIDNET Report

Journal of Clinical Immunology (2024)

John McDonnell Kimberley Cousins M. Elizabeth M. Younger Adam Lane Hassan Abolhassani

Abstract Background The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. Objective To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. Methods We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. Results Physicians entered data on 1245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least one COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication, and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p < 0.001), ICU admission (2.8% versus 7.6%, p = 0.013), and death (2.3% versus 4.3%, p = 0.202) in patients who had COVID-19 were lower in patients who received vaccination prior to infection. In adjusted logistic regression analysis, not having at least one COVID-19 vaccine significantly increased the odds of hospitalization and ICU admission. Conclusion Vaccination for COVID-19 in the IEI population appears safe and attenuates COVID-19 severity.

10.1007/s10875-023-01613-5

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The effect of osteopathic manipulative treatment on chronic rhinosinusitis

Journal of Osteopathic Medicine (2025)

Marija Rowane Ashwin Shankar Supriya Nagireddi Amanpreet Kalkat Cheryl Hammes

Abstract Context Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease of the paranasal sinuses that may significantly impair quality of life. CRS may also benefit from the application of manual techniques through osteopathic manipulative treatment (OMT), which aims to improve venous and lymphatic circulation, sympathetic and parasympathetic outflow, and cervicothoracic somatic dysfunction. Objectives This study aimed to assess whether OMT focused on lymphatic drainage of cranial structures can provide immediate, as well as sustained, relief of CRS symptoms. Methods This prospective, single-blinded study (WCG IRB study number: 1359444) was conducted at an allergy/immunology practice. Study participants included 43 adult patients, with a diagnosis of CRS, refractory to conventional medical therapy, with prior exposure to OMT. Patients consented to the study and were assigned by the provider to the OMT group or the control group 50/50. A four-question, 5-point Likert scale survey inquiring about the severity of nasal congestion, postnasal drainage, and facial or sinus pain/pressure, as well as the appreciation of the opportunity for an alternative therapy, was administered prior to the intervention. An OMT sequence was applied by the same osteopathic physician to each OMT group participant in the following order: thoracicinlet release, venous sinus drainage, occipital-atlantal decompression, thoracic paraspinal inhibition, facial sinus pressure, and Galbreath technique. A structural examination involving light touch was applied to the control group participants. The same 5-point Likert scale survey was administered immediately after the intervention. Participants were provided a blank copy of the survey to save and complete 10 days after the intervention. A paired t -test was applied for statistical comparison between the pre- and postsurveys. Results A total of 43 patients, including 22 patients in the treatment group (51.1 %) and 21 (48.8 %) patients in the control group, consented to and participated in the study, from May 1 to 30, 2024. Study demographics included 76.7 % females (n=33), 23.3 % males (n=10), 97.7 % White (n=42), and they patients had an average age of 54.4 years. Surveys administered before and immediately after the intervention were completed by 100 % of the study participants. All three surveys, including the presurvey and postsurvey completed immediately after and 10 days after the intervention, were completed by 60.5 % of the study participants. The OMT group pre-vs. immediate postsurvey results scored a statistically significant decrease in the severity of nasal congestion (p=0.001), postnasal drainage (p=0.002), and facial or sinus pain or pressure (p=0.0004). Conclusions Our single-blinded, prospective survey findings suggested that there was a benefit of OMT application for the immediate relief of CRS symptoms, predominantly in alleviating the severity of sinus pain or pressure. This study is the first large study (n=43) with a control group that shows that OMT techniques improve immediate CRS symptom relief of nasal congestion, postnasal drainage, and facial or sinus pain/pressure when compared to the pretreatment survey. Our study also demonstrated that the symptomatic relief by OMT of rhinosinusitis was not sustained in 10 days. OMT offers a safe, nonpharmacological complementary therapy to relieve lymphatic congestion and improve mucociliary clearance in CRS.

Manual therapy

Sinus (botany)

10.1515/jom-2024-0122

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COVID-19 Vaccination in Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: a USIDNET Report

Carolina Digital Repository (University of North Carolina at Chapel Hill) (2024)

John McDonnell Kimberley Cousins M. Elizabeth M. Younger Adam Lane Hassan Abolhassani

2019-20 coronavirus outbreak

10.17615/ehrf-dc77

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