Immunodeficiency Evaluation And Treatment- Allergy/Immunology

Doctor: Immunologist physician

What is immunodeficiency?

Immunodeficiency classically manifests as recurring infections. It can be either primary (genetically determined, normally establishing during infancy or childhood) or secondary (acquired).

Evaluation:

Patient’s medical history, physical examination, family history of any immune system diseases, and various immune function tests are done for the evaluation of immunodeficiency.

Following tests are done for the evaluation:

• Blood test: This test helps to determine if the patient has usual levels of infection-fighting proteins (immunoglobulin) in the blood. This test also measures the levels of blood cells and immune system cells.  Moreover, blood tests also help to determine if patient’s immune system is producing proteins which can identify and kill foreign particles such as bacteria or viruses.
• Prenatal testing: Prenatal testing is done by collecting sample of the amniotic fluid, blood or cells from the tissue which would become the placenta. These samples are tested for presence of any abnormalities. Sometimes DNA testing is done to identify any genetic defect.

Treatment:

Treatment options for immunodeficiency mainly include management of infections and boosting the immune system.

• Management of infections:
  • Treatment of infections: Antibiotics are prescribed to treat infections. In cases of infections when patient does not respond to antibiotics, hospitalization and intravenous (IV) antibiotics are recommended.
  • Prevention of infections: For some patients, in order to prevent any respiratory infections and permanent damage to the lungs and ears, antibiotics are prescribed for long-term.
  • Treatment of symptoms: Medicines such as ibuprofen are recommended to relieve pain and fever. Decongestants for sinus congestion and expectorants to thin mucus in the airways are also helpful to relieve symptoms caused by infections.
• Treatment to boost the immune system:
  • Immunoglobulin therapy:  Immunoglobulin contains antibody proteins that are necessary for the immune system to fight infections. Immunoglobulins can be injected directly into a vein (IV treatment) or inserted underneath the skin (subcutaneous infusion). IV treatment is required every few weeks and subcutaneous infusion is required once or twice a week.
  • Interferon-gamma therapy: Interferons help to fight viruses and stimulate immune system cells. Interferon-gamma is given as an injection three times a week.
  • Growth factors: If immunodeficiency is caused due to lack of certain white blood cells, treatment with growth factors can be helpful to increase the levels of immune-strengthening white blood cells.

References:

• https://www.msdmanuals.com/professional/immunology-allergic-disorders/immunodeficiency-disorders/approach-to-the-patient-with-suspected-immunodeficiency
• https://www.mayoclinic.org/diseases-conditions/primary-immunodeficiency/diagnosis-treatment/drc-20376910

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