Moraes-Fontes, Maria FranciscaHsu, Amy P.Caramalho, IrisMartins, CatarinaAraújo, Ana CarolinaLourenço, FilipaTaulaigo, Anna V.Lladó, AnaHolland, Steven M.Uzel, Gulbu2017-12-072017-12-072017-12-05Clinical Case Reports 2017; 5(12): 2066–2070http://hdl.handle.net/10400.7/816Further funders are not indicated in the document. There is no public supplementary material available for this publication. This deposit is composed by the main article, and it hasn't any supplementary materials associated.Primary immunodeficiency disorders are rarely diagnosed in adults but must be considered in the differential diagnosis of combined recurrent infections and autoimmune disease. We describe a patient with CTLA-4 haploinsufficiency and an abnormal regulatory T-cell phenotype. Unusually, infections were more severe than autoimmunity, illustrating therapeutic challenges in disease course.engCTLA-4 mutationEvans syndromehypogammaglobulinemiasepsisjournal article10.1002/ccr3.1257