Primary immunodeficiency investigation in patients during and after hospitalization in a pediatric intensive care
Érica Suavinho1, Ana Carolina R de Nápolis1, Gesmar Rodrigues S Segundo2
1Hospital de Clinicas, UFU, Uberlandia, MG, Brasil.
Insights
Active screening for primary immunodeficiencies (PID) is rarely performed in pediatric intensive care units. This study found that only 13.2% of severe infection cases underwent PID investigation, highlighting a critical gap in patient care.
Area of Science:
- Pediatric critical care medicine
- Immunology
- Infectious diseases
Background:
- Severe infections in children admitted to the Pediatric Intensive Care Unit (PICU) can be indicative of underlying primary immunodeficiencies (PID).
- Early diagnosis and management of PID are crucial for improving patient outcomes and preventing recurrent infections.
Purpose of the Study:
- To evaluate the frequency of active screening for primary immunodeficiencies (PID) in pediatric patients with severe infections admitted to a specific PICU.
- To determine if standard diagnostic workups for PID were initiated in this patient cohort.
Main Methods:
- A retrospective study was conducted analyzing patient records from January 2011 to January 2012.
- Data from patients with severe infections admitted to the PICU were reviewed to assess for initial PID investigations, including blood counts and immunoglobulin levels.
Main Results:
- Out of 53 children hospitalized with severe infections, only 7 (13.2%) received an initial PID investigation.
- Among those investigated, 5 out of 7 (71.4%) were diagnosed with PID, including alterations in immunoglobulin G (IgG) levels, cyclic neutropenia, and Wiskott-Aldrich syndrome.
Conclusions:
- Routine screening for primary immunodeficiencies is not consistently performed in the Pediatric Intensive Care Unit for patients with severe infections.
- The findings underscore the need to implement systematic PID investigations in critically ill pediatric patients to ensure timely diagnosis and appropriate treatment.
Objective:
To analyze whether the patients with severe infections, admitted in the Pediatric Intensive Care Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia, underwent the active screening for primary immunodeficiencies (PID).
Methods:
Retrospective study that assessed the data records of patients with any severe infections admitted in the Pediatric Intensive Care Unit, covering a period from January 2011 to January 2012, in order to confirm if they performed an initial investigation for PID with blood count and immunoglobulin dosage.
Results:
In the studied period, 53 children were hospitalized with severe infections in the Pediatric Intensive Care Unit, and only in seven (13.2%) the initial investigation of PID was performed. Among these patients, 3/7 (42.8%) showed quantitative alterations in immunoglobulin G (IgG) levels, 1/7 (14.3%) had the diagnosis of cyclic neutropenia, and 1/7 (14.3%) presented thrombocytopenia and a final diagnosis of Wiskott-Aldrich syndrome. Therefore, the PID diagnosis was confirmed in 5/7 (71.4%) of the patients.
Conclusions:
The investigation of PID in patients with severe infections has not been routinely performed in the Pediatric Intensive Care Unit. Our findings suggest the necessity of performing PID investigation in this group of patients.
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