Contents
Immunodeficiencies are disorders of the immune system characterized by a reduced or no defense against microbes such as bacteria, viruses and parasites.
There are two main types of immunodeficiency: primary, genetically determined and secondary, resulting from a past disease or the action of iatrogenic factors. We can also divide immunodeficiencies into: humoral immunodeficiency, i.e. a disorder involving antibodies and cellular immunity, affecting the cells of the immune system.
Epidemiology
Primary immunodeficiency is by far the most common isolated IgA deficiencywhich affects 1 in 500 children. The remaining primary immunodeficiencies occur in 1 / 10 children.
Many immune disorders appear in boys who constitute about 70% of patients with this problem. They are more predisposed due to the X-linked inheritance of many disorders of this type.
Maturation of the immune system
The group most exposed to infections are children attending nurseries or kindergartens, because at this time the child’s immune system is only learning to recognize pathogens and does not yet have fully efficient defense mechanisms in the form of antibodies and immune memory cells. These children have respiratory infections 6-8 times a year. After this period, the incidence of infections decreases significantly, which indicates a greater maturity of the immune system. Children up to 6 months of age get sick much less often because they have the antibodies that they received from their mother. After this period, their level drops significantly and the child acquires the ability to synthesize them on its own and develops its proper immunity.
If infections tend to occur more frequently or are severe and recur, they should be resolved diagnostics for immunodeficiencies. However, it is difficult due to the prevalence of infections, also in children with a normal immune system.
Symptoms of immunodeficiency
They most often concern:
- respiratory system
Increased susceptibility to infections, especially severe, chronic and recurrent respiratory tract infections, especially pneumonia, bronchitis, and ear infections.
- digestive system
It is quite common for the first symptom of immunodeficiency to be chronic diarrhea caused by a parasite Guard lamblia, rotavirus or fungi, leading to malnutrition and malnutrition disorders
- skin
Ulcers of the skin and mucous membranes, recurrent abscesses and boils, persistent yeast inflammatory lesions of the skin and mucous membranes, severe herpes infections, numerous and large ordinary warts should suggest immunodeficiency.
Immunodeficiency manifests itself in many ways. Patients often manifest it with a lack of body weight and height. In addition, in children with X-linked agammaglobulinemia, the lack of palatine tonsils is noticeable, while in patients with common variable immunodeficiency they are magnified. Oral fungal infection may be associated with a deficiency of cellular immunity or granulocyte dysfunction. X-linked hyper IgM syndrome is associated with enlargement of the liver and spleen.
To prevent drops in immunity in children, we recommend the DuoLife SunVital Kids dietary supplement. The preparation, thanks to fruit extracts of grapes, acerola and wild rose, is a wealth of vitamins and minerals and strengthens the immune system in children.
Diagnostic tests
Distinguishing immunodeficiency from the variant of the norm requires a lot of diagnostic tests. It is necessary to perform a complete blood count with a percentage image, IgM, IgG and IgA antibody levels, skin tests of delayed hypersensitivity, evaluation of the complement system, chest radiograph and appropriate cultures. More specialized tests are the next stage of diagnostics.
Earlier diagnosis is associated with faster treatment implementation and better prognosis. In order to improve the diagnosis, a list has been compiled symptoms which should be an indication for the diagnosis of the immune system (wg The Jeffrey Modell Foundation Medical Advisory Board):
- eight or more respiratory or ear infections in a year
- two or more sinusitis in a year
- antibiotic therapy for 2 months or more with a slight improvement in clinical condition
- two or more pneumonia in a year
- failure to gain weight or inhibition of normal growth in a child with recurrent infections
- repeated deep skin or organ abscesses
- chronic mycoses of the mouth or skin in children over 1 year of age
- the need for long-term use of intravenous antibiotics to control the infection
- two or more severe infections such as: brain, bone, skin and sepsis
- family history suggesting primary immunodeficiencies
Treatment
- maintaining proper hygiene (careful hand washing, taking care of oral hygiene, etc.) to avoid infection
- intensive antibiotic therapy of infections
- prophylaxis of infections with antimicrobial agents
- contraindicated administration of vaccines containing “live” microorganisms, ie: against chicken pox, against measles, mumps and rubella (MMR) and against poliomyelitis. The child should be vaccinated with an inactivated poliomyelitis vaccine, while members of the child’s immediate family should receive the MMR and varicella vaccine.
- replacement immunoglobulin preparations in humoral immunodeficiency
- irradiated blood preparations if it is necessary
- bone marrow transplant
Text: lek. Jagoda Kumik
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