Evidence map›Paper›PMID 41831046›Full record

ArticleJournal of clinical immunology2026

Syndromic Inborn Errors of Immunity in TREC-Newborn Screening: 5-year Experience from the German Screening Program.

Lea Graafen, Carsten Speckmann, Shahrzad Bakhtiar, Horst V Bernuth, Kai Lehmberg, Peter Bader, Ulrich Baumann, Rita Beier, Stephan Borte, Inken Brockow and 23 more

Abstract read
In one paragraph

Article in Journal of clinical immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Interpreting abnormal severe combined immunodeficiency (SCID) newborn screens: Perinatal predictors and clinical implications.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026
    Article
  2. 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

33 authors.

Lea GraafenDepartment of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, Heinrich-Heine- University, University Hospital Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany.
Carsten SpeckmannInstitute for Immunodeficiency, Centre for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany.
Shahrzad BakhtiarDivision for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.
Horst V BernuthDepartment of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health (BIH), Berlin, Germany.
Kai LehmbergDivision of Paediatric Stem Cell Transplantation and Immunology, Clinic for Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Peter BaderDivision for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.
Ulrich BaumannDepartment of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany.
Rita BeierPaediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany.
Stephan BorteJeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiency Diseases, Immune Deficiency Centre Leipzig, Hospital St. Georg, Leipzig, Germany.
Inken BrockowScreening Centre, Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany.
E Graham DaviesDepartment of Immunology and Gene Therapy, Great Ormond Street Hospital for Children, London, UK.
Maximilian HartmannDivision of Paediatric Stem Cell Transplantation and Immunology, Clinic for Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Ursula HolzerUniversity Children's Hospital, Eberhard Karls University, Tübingen, Germany.
Christian KlemannDepartment for Paediatric Immunology, Rheumatology & Infectiology, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.
Alexandra Y KreinsDepartment of Immunology and Gene Therapy, Great Ormond Street Hospital for Children, London, UK.
Renate KrügerDepartment of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health (BIH), Berlin, Germany.
Udo KontnyDivision of Paediatric Haematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Hans-Jürgen LawsDepartment of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, Heinrich-Heine- University, University Hospital Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany.
Andrea MeinhardtPaediatric Haematology, Oncology and Immunodeficiencies, University Children's Hospital Giessen, Giessen, Germany.
Henner MorbachDepartment of Paediatrics, University Hospital of Würzburg, Würzburg, Germany.
Nora Naumann-BartschDivision of Paediatric Haematology and Oncology, Department of Paediatrics, University Hospital Erlangen, Erlangen, Germany.
Tobias RothoeftDepartment of Paediatrics, Paediatric Intensive Care Medicine, Catholic Hospital Bochum, Ruhr-University of Bochum, Bochum, Germany.
Dominik T SchneiderClinic of Paediatrics, Municipal Hospital Dortmund, Dortmund, Germany.
Andre WillaschDivision for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.
Austen WorthDepartment of Immunology and Gene Therapy, Great Ormond Street Hospital for Children, London, UK.
Markus G SeidelResearch Unit for Paediatric Haematology and Immunology, Division of Paediatric Haemato-Oncology, Department of Paediatric and Adolescent Medicine, Medical University Graz, Graz, Austria.
Michael H AlbertDepartment of Paediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians- Universität München, Munich, Germany.
Stephan EhlInstitute for Immunodeficiency, Centre for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany.
Fabian HauckDepartment of Paediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians- Universität München, Munich, Germany.
Manfred HönigDepartment of Paediatrics, University Medical Centre Ulm, Ulm, Germany.
Ansgar SchulzDepartment of Paediatrics, University Medical Centre Ulm, Ulm, Germany.
Catharina Schuetz *Department of Paediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden, 01307, Germany. catharina.schuetz@ukdd.de.
Sujal Ghosh *Department of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, Heinrich-Heine- University, University Hospital Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany. sujal.ghosh@med.uni-duesseldorf.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

TREC-NBS identifies patients with inborn errors of immunity (IEI) and syndromic features, but uncertainty remains regarding their immunological management. To address this, syndromic patients detected by TREC-NBS in Germany between August 2019 and April 2024 were systematically analyzed, including phenotype, treatment, and outcomes. National registries were screened, and data were completed by the treating centres. A total of 77 syndromic patients were identified, with 22 different gene defects found in 72 individuals (93.5%). Primary thymic deficiency was present in 64% (49/77), most commonly due to 22q11.2 deletion syndrome (62%). Common clinical features included congenital heart disease (57%), facial/skeletal abnormalities (53%), and neurological symptoms (36%). Definitive treatments were provided promptly in eligible patients, including 6 thymus transplants and 6 hematopoietic stem cell transplants (HSCT). A watch-and-wait approach was applied to the remaining patients, with 34% (22/65) receiving prophylactic treatment. Recovery of CD3 + T-cell counts was limited to a minority. Overall survival was 89%, with a median follow-up of 32 months (range 0.5-60). To conclude, this is the first comprehensive study of syndromic IEI patients identified through TREC-NBS. The findings show that the German healthcare system enables both early prophylactic care and timely access to definitive therapies. Moving forward, interdisciplinary collaboration will be key to developing evidence-based management guidelines for this challenging patient group.

Indexed as

Neonatal ScreeningPrimary Immunodeficiency DiseasesChildChild, PreschoolFemaleGermanyHematopoietic Stem Cell TransplantationHumansInfantInfant, NewbornMalePhenotypeRegistriesT-LymphocytesNewborn screeningSCIDSyndromic inborn errors of immunityT-cell lymphocytopeniaT-cell receptor excision circlesThymic deficiency

Identifiers

PMID41831046
PMCPMC13031199

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Registered trials

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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.