Evidence map›Paper›PMID 41139764›Full record

ReviewImmunologic research2025

Rubella-associated granuloma in a patient with a compound heterozygous RAG1 defect and review of the literature.

Aysegul Akarsu, Gamze Sonmez, Ana-Iris Schiefer, H Nursun Ozcan, Meral Üner, Saliha Esenboga, Ali Duzova, Felicitas Oberndorfer, Seza Ozen, Mehmet Ayvaz and 2 more

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In one paragraph

Review in Immunologic research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Aysegul AkarsuDepartment of Pediatric Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Gamze SonmezHacettepe University Faculty of Medicine, Ankara, Turkey.
Ana-Iris SchieferDepartment of Pathology, Vienna University Faculty of Medicine, Vienna, Austria.
H Nursun OzcanDepartment of Pediatric Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Meral ÜnerDepartment of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Saliha EsenbogaDepartment of Pediatric Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Ali DuzovaDepartment of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Felicitas OberndorferDepartment of Pathology, Vienna University Faculty of Medicine, Vienna, Austria.
Seza OzenDepartment of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Mehmet AyvazDepartment of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Uğur ÖzçelikDepartment of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Deniz CagdasDepartment of Pediatric Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey. deniz.ayvaz@hacettepe.edu.tr.ORCID 0000-0003-2213-4627

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recombination-activating gene (RAG) 1-2 deficiencies have a phenotype spectrum from severe combined to combined immunodeficiency (CID). We presented a comprehensive immunologic/genetic/radiologic/pathological, and virologic evaluation results of a patient with granuloma and reviewed the medical literature in 2022-2025 period for rubella virus (RuV)-associated granulomas in inborn errors of immunity (IEI). We evaluated a 17-year-old male patient with a necrotic, ulcerated, and exudative lesion extending over the right foot and leg at the edge of amputation. He had a history of recurrent pneumonia and bronchiectasis. Further evaluation revealed systemic granulomas (skin, spleen) in addition to the extremity lesions and low T- and B-, and naive CD4 + T cell numbers. In addition to a defined heterozygous RAG1 mutation(c.1421 G > A, R474H) detected with NGS PID-panel analysis, Sanger sequencing analysis confirmed patient`s CID diagnosis by revealing another heterozygous mutation(c.1181 G > A, R394Q). Histopathology demonstrated necrotizing granulomas with vasculitis and RT-PCR study from the splenic granulomas revealed RuV. The ulceration and exudative extremity lesions regressed with a scar within two months after the initiation of the anti-TNF therapy. In addition to CID therapy, hematopoietic stem cell transplantation was planned from his HLA-matched sibling donor. RuV-associated granuloma usually develop in the first 12 years and accompany gene defects related to Griscelli disease and familial hemophagocytic lymphohistiocytosis (HLH) in the medical literature. Early, comprehensive diagnostic workup for granuloma could further reveal the RuV's role in granulomatous inflammation in IEI, leading to targeted therapy to improve outcomes. Thorough genetic investigation in the presence of granuloma is crucial.

Indexed as

GranulomaHomeodomain ProteinsRubellaAdolescentHeterozygoteHumansMaleMutationHomeodomain ProteinsRAG-1 proteinCombined immunodeficiencyGranulomatous diseaseRAG1 geneRubella virus

Identifiers

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.