AUTHOR=Liu Chengzhu , Xie Zhiwei , Wang Min , Chu Jinhua , Yang Linhai , Zhang Kunlong , Huang Lingling , Tu Songji , Cai Huaju , Wu Zhengyu , Wang Liyuan , Wang Ningling TITLE=Case Report: Successful treatment of spondyloenchondrodysplasia with immune dysregulation using tofacitinib and ruxolitinib: a report of two pediatric cases JOURNAL=Frontiers in Pharmacology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1588003 DOI=10.3389/fphar.2025.1588003 ISSN=1663-9812 ABSTRACT=Spondyloenchondrodysplasia with immune dysregulation (SPENCDI) is autosomal recessive hereditary disease caused by tartrate resistant acid phosphatase 5 (ACP5) mutations. The symptoms mainly involve the bone, immune system and nervous system, and the typical manifestations are short stature, abnormal development of long diaphyseal epiphysis, flat vertebra, and prone to various autoimmune diseases. Some children have muscle spasm, mild mental retardation, intracranial calcification and other neurological manifestations. Here we reported two cases of SPENCDI caused by a new mutation in ACP5. The clinical manifestations were autoimmune hemolytic anemia, immune thrombocytopenia, abnormal bone development, intracranial calcification, short stature, and growth retardation. The patients were girls and diagnosed with SPENCDI by genetic test.