CD4 and Decreased circulating immunoglobulin concentration: Indeed, in juvenile dermatomyositis (JDM), immune dysregulation leads to skewing of blood CXCR5+ Th (TFH) subsets towards Th2 and Th17TFH [24], while in JDM and other autoimmune conditions as systemic lupus erythematosus (SLE) or Sjogren's disease, increased levels of functional CXCR5+CD4+ T cells lead to hypergammaglobulinemia and autoantibody synthesis [49–51] in CVID hypogammaglobulinemia or selected immunoglobulin deficiency occurs, probably as a result of impaired B cell maturation [52].