Inborn Errors of Immunity and Worries During the Monkeypox Outbreak.

Inborn errors of immunity (IEI) are disorders characterized by the impaired development and functioning of the immune system components. These errors can affect cellular immunity, humoral immunity, or both, predisposing patients to localized and systemic manifestations (for the most recent update on the classification of IEI, see [1](#ref-0001)). Among various signs and symptoms, increased susceptibility to infections and autoimmune and inflammatory conditions with a high tendency to involve the skin, lungs, and gut are most-documented. With the re-emergence of the monkeypox (MPX) outbreak in 2022 and a new picture that it has presented, i.e., the global spread of the disease and the high prevalence in patients with human immunodeficiency syndrome (HIV) [2](#ref-0002), worries are increasing about the possible threat of monkeypox virus (MPXV) to affect patients with IEI. As of November 04, 2022, 109 countries reported a total of more than 78,000 MPXV-infected cases, with a death rate of about 0.01% [3](#ref-0003). During this outbreak, males who have sex with other males (MSM) have constituted the majority of the MPXV-infected population [4,5](#ref-0004). Moreover, people with HIV account for about 40% of this population and exhibit a more severe disease course, as represented in the higher need for hospitalization [6](#ref-0006). To date, no infection with MPXV has been reported in patients with IEI; however, high susceptibility of immunocompromised people to this infection is alarming for people with IEI and their caregivers. Below address a few important questions concerning patients with IEI during this outbreak. This article is protected by copyright. All rights reserved.