CYBB and methylmalonic acidemia: This highlights that CA-IFIs are more closely associated with immune, metabolic, and genetic disorders (e.g., neonatal lupus, methylmalonic acidemia, CYBB mutations) rather than typical HA-IFIs risk factors such as central catheters or parenteral nutrition.[15] Our findings are consistent with a large Chinese multicenter study that linked IFIs to congenital immunodeficiencies (e.g., CYBB, CD40LG mutations).[16] The presence of CA-IFIs may indicate underlying undiagnosed genetic or immune defects.