Publications by authors named "Mukesh Desai"

Purpose: Wiskott-Aldrich syndrome (WAS) is an X-linked genetic disorder characterized by distinctive features including microthrombocytopenia, eczema and recurrent infections. In the present study we report clinical, immunological and molecular spectrum of 41 WAS patients diagnosed over last five years.

Methods: Clinical and family history was collected from case records.

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  • Ghosal hematodiaphyseal dysplasia (GHDD) is a rare genetic disorder affecting bone development, characterized by issues like diaphyseal dysplasia of long bones and anemia that responds to steroids, caused by mutations in the TBXAS1 gene.
  • Two cases are presented: a 3-year-old boy with pallor and ecchymosis diagnosed with GHDD due to bicytopenia and bone marrow fibrosis, and a 20-month-old girl with symptoms including bloody stools and anemia, confirmed through genetic testing.
  • Early diagnosis and treatment with steroids can significantly improve patient outcomes, reducing transfusion needs and preventing further bone damage, which contributes to better growth
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Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(S2):S104-S216.

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  • * The study involves identifying CSA patients using a targeted next-generation sequencing (t-NGS) panel, discovering mutations related to microcytic anaemia, and assessing their response to treatments such as pyridoxine and blood transfusions.
  • * Researchers found various genetic variants among patients, primarily in European populations, and used PyMoL software to study how these mutations affect protein structure and function, aiming for a deeper understanding of CSA genetics.
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Background & Objectives: Accurate diagnosis of immunodeficiencies requires a critical comparison of values with age-matched controls. In India, the existing reference values for rare lymphocyte subsets are currently not available and we rely on the data originating from other countries for the interpretation of the results. Furthermore, there is limited information on normal variation for these rare-subset parameters in Indian children.

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  • Hematopoietic stem cell transplantation for primary immunodeficiency disorders has improved significantly since 1968, with long-term survival rates in India (62.5% to 75%) being lower than those in high-income countries (90%).
  • This study analyzed data from a charitable hospital on 21 pediatric patients who underwent transplantation between March 2019 and March 2022, focusing on infections, immune recovery, and survival rates.
  • Results showed a median age of 3 years at transplantation, with high engraftment success (94%) and a 95% overall survival rate at one year, demonstrating effective immune reconstitution and minimal serious complications.
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The emergence of vaccine-derived polioviruses (VDPVs) in patients with Primary Immunodeficiency (PID) is a threat to the polio-eradication program. In a first of its kind pilot study for successful screening and identification of VDPV excretion among patients with PID in India, enteroviruses were assessed in stool specimens of 154 PID patients across India in a period of two years. A total of 21.

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The clinical syndrome caused by cleavage-resistant RIPK1 is known as CRIA (Cleavage-resistant RIPK1-induced autoinflammatory) syndrome. We present a family with three generations affected by CRIA syndrome. Our index patient (P1), a boy born of a non-consanguineous marriage, developed recurrent episodes of fever after 5 months of age, with variable periodicity.

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To estimate the prevalence of monogenic inborn errors of immunity in patients with autoimmune diseases (AID), the study included 56 subjects (male:female ratio: 1.07) with mean age of onset of autoimmunity 7 years (4 months-46 years). 21/56 had polyautoimmunity.

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Individuals with primary immunodeficiencies who are infected with vaccine-derived polioviruses may continue to shed poliovirus for months and go undetected by surveillance programmes of acute flaccid paralysis. These patients therefore pose a risk of initiating poliovirus outbreaks that jeopardize efforts towards global polio eradication. To identify these individuals, we designed a study protocol for the establishment of a network for surveillance of immunodeficiency-related vaccine-derived poliovirus in India.

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DOCK8 deficiency affects various cell subsets belonging to both the innate and adaptive immune systems. Clinical diagnosis is challenging, as many cases present with severe atopic dermatitis as the only initial manifestation. Though flow cytometry helps in the presumptive diagnosis of DOCK8-deficient patients by evaluating their DOCK8 protein expression, it requires subsequent confirmation by molecular genetic analysis.

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Background: In 2014, germline signal transducer and activator of transcription (STAT) 3 gain-of-function (GOF) mutations were first described to cause a novel multisystem disease of early-onset lymphoproliferation and autoimmunity.

Objective: This pivotal cohort study defines the scope, natural history, treatment, and overall survival of a large global cohort of patients with pathogenic STAT3 GOF variants.

Methods: We identified 191 patients from 33 countries with 72 unique mutations.

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The energy metabolism of myeloid cells depends primarily on glycolysis. 1,5-Anhydroglucitol (1,5AG), a natural monosaccharide, is erroneously phosphorylated by glucose-phosphorylating enzymes to produce 1,5-anhydroglucitol-6-phosphate (1,5AG6P), a powerful inhibitor of hexokinases. The endoplasmic reticulum transporter (SLC37A4/G6PT) and the phosphatase G6PC3 cooperate to dephosphorylate 1,5AG6P.

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  • Autosomal recessive (AR) STAT1 deficiency significantly impairs the immune response to various infections, making patients highly susceptible to viral and mycobacterial diseases.
  • An international study of 32 patients revealed that complete deficiency leads to more severe outcomes, including a higher mortality rate and serious reactions to vaccines.
  • Hematopoietic stem cell transplantation shows promise as a treatment, with a 64% survival rate for those who undergo the procedure, underscoring the importance of early diagnosis and differentiation between complete and partial deficiency forms.
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  • - The study focuses on Wiskott Aldrich syndrome (WAS), a condition that causes bleeding, infections, eczema, autoimmune issues, and cancer, and it emphasizes the increased recognition and diagnostics of WAS in India over the last decade across multiple centers.
  • - Data from six primary immunodeficiency disease centers were compiled, analyzing clinical details of 108 patients with WAS, revealing symptoms such as bleeding (92.6%), infections (84.2%), eczema (78.9%), and autoimmune manifestations (40%).
  • - Genetic analysis identified 47 variants in 67 cases, with the most common being nonsense and missense mutations; treatment included prophylactic intravenous immunoglobulin for 52 patients and hematopoietic stem cell
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  • Systemic autoinflammatory diseases (SAID) are rare genetic disorders causing chronic inflammation and are linked to defects in immune signaling genes, with a study conducted on Indian patients to analyze their clinical and molecular characteristics.
  • Data from six medical centers in India was collected, revealing 107 patients with SAID, with 29 excluded due to incomplete information; the study identified various subtypes of SAID, such as type 1 interferonopathies and inflammasome-related diseases.
  • Most patients experienced significant delays in diagnosis, and treatments included corticosteroids and immunosuppressive drugs, highlighting the complexity of managing these conditions.
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