Scholars@Duke
Patricia Lynne Lugar

Patricia Lynne Lugar

Associate Professor of Medicine
Medicine, Pulmonary, Allergy, and Critical Care Medicine
patricia.lugar@duke.edu
1821 Hillandale Rd, Suite 25A, Durham, NC 27705

Selected Publications

Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial.

Journal Article JAMA Intern Med · September 1, 2023 IMPORTANCE: Fewer than 5% of patients labeled with a penicillin allergy are truly allergic. The standard of care to remove the penicillin allergy label in adults is specialized testing involving prick and intradermal skin testing followed by an oral challe ... Full text Open Access Link to item Cite

Immunoglobulin Deficiency and the Unified Airway.

Journal Article Otolaryngol Clin North Am · February 2023 Primary Ig deficiencies are a heterogeneous group of disorders with widespread implications for the unified airway. Manifestations can vary greatly, with some patients being asymptomatic, whereas others suffering from acute and chronic life-threatening pat ... Full text Link to item Cite

Systemic IgG exposure and safety in patients with primary immunodeficiency: a randomized crossover study comparing a novel investigational wearable infusor versus the Crono pump.

Journal Article Immunotherapy · November 2022 Aim: A novel, Investigational Wearable Infusor (IWI) was evaluated in a randomized, controlled, crossover, open-label study to determine if its delivery of subcutaneous immunoglobulin (IgPro20) achieved a comparable area under the concentration-time curve ... Full text Link to item Cite

Long-term prevention of hereditary angioedema attacks with lanadelumab: The HELP OLE Study.

Journal Article Allergy · March 2022 BACKGROUND: The aim was to evaluate long-term effectiveness and safety of lanadelumab in patients ≥12 y old with hereditary angioedema (HAE) 1/2 (NCT02741596). METHODS: Rollover patients completing the HELP Study and continuing into HELP OLE received one l ... Full text Link to item Cite

Acquired angioedema in B cell lymphoproliferative disease: A retrospective case series.

Journal Article Clin Exp Immunol · December 2021 Acquired angioedema due to C1-inhibitor (C1-INH) deficiency (AAE-C1-INH) is rare and is associated with underlying lymphoproliferative diseases. C1-INH deficiency may be due to neoplastic over-consumption of C1-INH and the generation of anti-C1-INH autoant ... Full text Link to item Cite

Evaluation of a Pharmacist-Led Penicillin Allergy Assessment Program and Allergy Delabeling in a Tertiary Care Hospital.

Journal Article JAMA Netw Open · May 3, 2021 IMPORTANCE: Penicillin allergies are frequently mislabeled, which may contribute to use of less-preferred alternative antibiotics. OBJECTIVE: To evaluate a pharmacist-led allergy assessment program's association with antimicrobial use and clinical outcomes ... Full text Link to item Cite

Impact of lanadelumab on health-related quality of life in patients with hereditary angioedema in the HELP study.

Journal Article Allergy · April 2021 BACKGROUND: An objective of the phase 3 HELP Study was to investigate the effect of lanadelumab on health-related quality of life (HRQoL) in patients with hereditary angioedema (HAE). METHODS: Patients with HAE-1/2 received either lanadelumab 150 mg every ... Full text Open Access Link to item Cite

Safety and Tolerability of Manual Push Administration of Subcutaneous IgPro20 at High Infusion Rates in Patients with Primary Immunodeficiency: Findings from the Manual Push Administration Cohort of the HILO Study.

Journal Article J Clin Immunol · January 2021 PURPOSE: To evaluate the safety and tolerability of IgPro20 manual push (also known as rapid push) infusions at flow rates of 0.5-2.0 mL/min. METHODS: Patients with primary immunodeficiency (PID) with previous experience administering IgPro20 (Hizentra®, C ... Full text Link to item Cite

Lanadelumab demonstrates rapid and sustained prevention of hereditary angioedema attacks.

Journal Article Allergy · November 2020 BACKGROUND: Lanadelumab demonstrated efficacy in preventing hereditary angioedema (HAE) attacks in the phase 3 HELP Study. OBJECTIVE: To assess time to onset of effect and long-term efficacy of lanadelumab, based on exploratory findings from the HELP Study ... Full text Link to item Cite

Diagnostic interpretation of genetic studies in patients with primary immunodeficiency diseases: A working group report of the Primary Immunodeficiency Diseases Committee of the American Academy of Allergy, Asthma & Immunology.

Journal Article J Allergy Clin Immunol · January 2020 Genetic testing has become an integral component of the diagnostic evaluation of patients with suspected primary immunodeficiency diseases. Results of genetic testing can have a profound effect on clinical management decisions. Therefore clinical providers ... Full text Link to item Cite

Things We Do For No Reason™: Failing to Question a Penicillin Allergy History.

Journal Article J Hosp Med · November 2019 Inspired by the ABIM Foundation's Choosing Wisely® campaign, the "Things We Do for No Reason™" (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR s ... Full text Link to item Cite

30-Year Review of Pediatric- and Adult-Onset CVID: Clinical Correlates and Prognostic Indicators.

Journal Article J Clin Immunol · October 2019 PURPOSE: To evaluate mortality risk factors in pediatric-onset common variable immunodeficiency disorders (CVID), we evaluated the largest single-institution cohort of pediatric-onset CVID patients. Previous publications on CVID have provided valuable desc ... Full text Link to item Cite

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Journal Article J Allergy Clin Immunol Pract · April 2019 Full text Link to item Cite

Low Serum IgE Is a Sensitive and Specific Marker for Common Variable Immunodeficiency (CVID).

Journal Article J Clin Immunol · April 2018 Although small prior studies have suggested that IgE can be low in common variable immunodeficiency (CVID), the workup for patients with recurrent infections and suspected hypogammaglobulinemia does not include the routine measurement of serum IgE. We soug ... Full text Link to item Cite

Cancer in primary immunodeficiency diseases: Cancer incidence in the United States Immune Deficiency Network Registry.

Journal Article J Allergy Clin Immunol · March 2018 BACKGROUND: We evaluated the overall and site-specific incidence of cancer in subjects with primary immunodeficiency diseases (PIDD) enrolled in the United States Immune Deficiency Network (USIDNET) registry compared with age-adjusted cancer incidence in t ... Full text Link to item Cite

Characterization of pediatric onset common variable immunodeficiency (CVID) in a large cohort

Conference Journal of Allergy and Clinical Immunology · February 2018 Full text Cite

Inpatient Penicillin Allergy Evaluation Program Enriches Anti-Microbial Stewardship Aims

Conference Journal of Allergy and Clinical Immunology · February 2018 Full text Cite

Common variable immunodeficiency non-infectious disease endotypes redefined using unbiased network clustering in large electronic datasets

Journal Article Frontiers in Immunology · January 9, 2018 Common variable immunodeficiency (CVID) is increasingly recognized for its association with autoimmune and inflammatory complications. Despite recent advances in immunophenotypic and genetic discovery, clinical care of CVID remains limited by our inability ... Full text Cite

Autosomal Dominant Hyper-IgE Syndrome in the USIDNET Registry.

Journal Article J Allergy Clin Immunol Pract · 2018 BACKGROUND: Autosomal dominant hyper-IgE syndrome (AD-HIES) is a rare condition. OBJECTIVE: Data from the USIDNET Registry provide a resource to examine the characteristics of patients with rare immune deficiency diseases. METHODS: A query was submitted to ... Full text Link to item Cite

Two Sides of the Same Coin: Pediatric-Onset and Adult-Onset Common Variable Immune Deficiency.

Journal Article J Clin Immunol · August 2017 PURPOSE: Common variable immunodeficiency (CVID) is a complex, heterogeneous immunodeficiency characterized by hypogammaglobulinemia, recurrent infections, and poor antibody response to vaccination. While antibiotics and immunoglobulin prophylaxis have sig ... Full text Link to item Cite

Enteropathy-associated T cell lymphoma subtypes are characterized by loss of function of SETD2.

Journal Article J Exp Med · May 1, 2017 Enteropathy-associated T cell lymphoma (EATL) is a lethal, and the most common, neoplastic complication of celiac disease. Here, we defined the genetic landscape of EATL through whole-exome sequencing of 69 EATL tumors. SETD2 was the most frequently silenc ... Full text Link to item Cite

Peri-operative Anaphylaxis: Evaluation and Management for Outpatient Testing

Conference Journal of Allergy and Clinical Immunology · February 2017 Full text Cite

Interrogating Genetic Susceptibility Loci in CVID and Autoimmunity

Conference Journal of Allergy and Clinical Immunology · February 2016 Full text Cite

Diagnostic Immunization with Bacteriophage ΦX 174 in Patients with Common Variable Immunodeficiency/Hypogammaglobulinemia.

Journal Article Front Immunol · 2014 PURPOSE: Use of the T cell-dependent neoantigen bacteriophage ΦX 174 has been described since the 1960s as a method to assess specific antibody response in patients with primary immunodeficiencies. We reviewed a cohort of patients at Duke University Medica ... Full text Link to item Cite

Exome Sequencing Reveals Novel Genetic Underpinnings of Common Variable Immune Deficiency (CVID)

Conference Journal of Allergy and Clinical Immunology · February 2013 Full text Cite

Genetic heterogeneity of diffuse large B-cell lymphoma.

Journal Article Proc Natl Acad Sci U S A · January 22, 2013 Diffuse large B-cell lymphoma (DLBCL) is the most common form of lymphoma in adults. The disease exhibits a striking heterogeneity in gene expression profiles and clinical outcomes, but its genetic causes remain to be fully defined. Through whole genome an ... Full text Link to item Cite

The genetic landscape of mutations in Burkitt lymphoma.

Journal Article Nat Genet · December 2012 Burkitt lymphoma is characterized by deregulation of MYC, but the contribution of other genetic mutations to the disease is largely unknown. Here, we describe the first completely sequenced genome from a Burkitt lymphoma tumor and germline DNA from the sam ... Full text Link to item Cite

Molecular characterization of circulating plasma cells in patients with active systemic lupus erythematosus.

Journal Article PLoS One · 2012 Systemic lupus erythematosus (SLE) is a generalized autoimmune disease characterized by abnormal B cell activation and the occurrence of increased frequencies of circulating plasma cells (PC). The molecular characteristics and nature of circulating PC and ... Full text Link to item Cite

Deep sequencing of the small RNA transcriptome of normal and malignant human B cells identifies hundreds of novel microRNAs.

Journal Article Blood · December 2, 2010 A role for microRNA (miRNA) has been recognized in nearly every biologic system examined thus far. A complete delineation of their role must be preceded by the identification of all miRNAs present in any system. We elucidated the complete small RNA transcr ... Full text Link to item Cite

Patterns of microRNA expression characterize stages of human B-cell differentiation.

Journal Article Blood · May 7, 2009 Mature B-cell differentiation provides an important mechanism for the acquisition of adaptive immunity. Malignancies derived from mature B cells constitute the majority of leukemias and lymphomas. These malignancies often maintain the characteristics of th ... Full text Link to item Cite

Analysis of somatic hypermutation in X-linked hyper-IgM syndrome shows specific deficiencies in mutational targeting.

Journal Article Blood · April 16, 2009 Subjects with X-linked hyper-IgM syndrome (X-HIgM) have a markedly reduced frequency of CD27(+) memory B cells, and their Ig genes have a low level of somatic hypermutation (SHM). To analyze the nature of SHM in X-HIgM, we sequenced 209 nonproductive and 9 ... Full text Link to item Cite

MicroRNAs Regulate Mature B Cell Differentiation

Journal Article BLOOD · November 16, 2008 Link to item Cite

Erratum: (Journal of Experimental Medicine (January 23, 2006) 203:1 (63-72))

Journal Article Journal of Experimental Medicine · February 20, 2006 Full text Cite

Regulation of the germinal center gene program by interferon (IFN) regulatory factor 8/IFN consensus sequence-binding protein.

Journal Article J Exp Med · January 23, 2006 Interferon (IFN) consensus sequence-binding protein/IFN regulatory factor 8 (IRF8) is a transcription factor that regulates the differentiation and function of macrophages, granulocytes, and dendritic cells through activation or repression of target genes. ... Full text Link to item Cite