Background and Objectives: Inborn errors of immunity are increasingly diagnosed in developing countries. Immunoglobulin replacement therapy (IGRT) remains the cornerstone of treatment in these patients, and its monitoring has gained importance for optimizing outcomes. We conducted a retrospective study to evaluate the relationship between IgG trough levels and infections in adults with inborn errors of immunity receiving IGRT. Materials and Methods: Adults diagnosed with primary immunodeficiency and receiving IGRT for at least six months were included. Serum IgG trough levels were measured, and infections during follow-up were systematically recorded. Results: A total of 31 adult patients (CVID: 29, XLA: 2) were analyzed. The mean follow-up was 13 months, with a mean serum IgG trough level of 815.8 ± 205.9 mg/dL, achieved with an average IGRT dose of 498.8 ± 93.0 mg/kg/month. Dose adjustments were made in 35.5% of patients, mostly due to weight changes and clinical indications. Overall, 74.2% of patients had at least one infection requiring antibiotics. Patients with mean IgG trough levels below 850 mg/dL had significantly higher rates of antibiotic-requiring infections (p = 0.032, Mann–Whitney U; mean difference = 0.109, 95% CI: 0.037–0.182; p = 0.005 via t-test). Multivariate regression confirmed that lower IgG trough levels were independently associated with higher antibiotic-requiring infection rates (B = −0.024, 95% CI: −0.045 to −0.002, p = 0.033), while IGRT dose and comorbidities were not significant. Conclusions: IGRT plays a key role in reducing antibiotic-requiring infections in patients with primary immunodeficiency. Regular monitoring and individualized dose adjustments may help optimize outcomes. Further prospective studies are needed to confirm these findings.

Introduction: Sarcoidosis is a disease with an autoimmune origin,capable of involving many systems.Treatment is not required in most cases due to frequent spontaneous remission which makes treatment indications controversial.Spontaneous remission occurs in 60-70% of patients while chronic and progressive course is observed in 10-30% of patients.The vast majority of patients recover or remain stable with corticosteroid therapy.Reported relapse is observed in the range of 16-74% of patients when corticosteroid is reduced or treatment is stopped.We aimed to investigate the relapse rates and factors affecting the relapse in patients diagnosed with sarcoidosis and followed at least 5 years. Method: We examined patients who applied to our hospital between 2000-2014 and diagnosed with sarcoidosis. Results: 3074 patients preliminary diagnosed with sarcoidosis were examined.After excluding patients who had no definitive diagnosis or 5-year follow-up and were diagnosed rather than sarcoidosis,967 patients were included in our study.76.9% of our cases were female.The average age was 46.5 ± 11.7.Patients presented with 57.4% dyspnea,60.7% cough and 32.8% chest pain.FEV1 was 87.4 ± 20.1%,FVC was 89.6 ± 19.0%,FEV1/FVC was 79.8 ± 8.1%.In DLCO 4.7% were heavy,14.4% were moderate, 40.8% were light and 40.1% were normal.Relapse rate was 16,6%.24.8% patients received treatment (%96,6 steroids).Hypercalciuria,advancing disease stage and low CO difussion capacity were meaningly higher in relapsed patients. Conclussion: Advancing disease stage and low CO difussion capacity were associated with relapse as mentioned recently.Hypercalciuria was found significant in patients recurrent.

Background: Biologic therapies can control severe asthma and may modify its natural history beyond symptom control. However, step‐down is not standardized, and its safety has not been clearly established. Methods: This single‐center retrospective cohort study reviewed adults with severe asthma on biologics (January 2019–May 2024). Step‐down strategies (discontinuation of add‐on therapy and/or inhaled corticosteroid [ICS] dose reduction) were described, success rates calculated, and clinical characteristics compared between groups with and without step‐down. Results: Fifty‐one patients were included, of whom 10 (19.6%) received omalizumab, 34 (66.7%) mepolizumab, and 7 (13.7%) benralizumab. After excluding 6 patients unsuitable for step‐down assessment, 45 patients were compared. Step‐down was attempted in 21 of these (46.7%) and succeeded in 17 (81.0%), defined as no systemic corticosteroid use, emergency visit, loss of control (ACT < 20), or exacerbation through the last visit. The most frequent interventions were ICS dose reduction ( n = 7, 33.3%) and montelukast discontinuation ( n = 7, 33.3%). Biologics had been received for a mean of 42.6 ± 14.0 months, and the reduced regimen was maintained for 8.15 ± 5.23 months. Compared with the non–step‐down group, the step‐down group had a higher proportion of males ( p = 0.005) and longer follow‐up ( p = 0.007). Conclusion: In this real‐world cohort, step‐down was feasible and appeared safe, with most patients maintaining the reduced regimen without deterioration in control or exacerbations. These findings support supervised treatment minimization in carefully selected, well‐controlled patients, adding real‐world evidence to a limited literature.