Allergic diseases in children with primary immunodeficiencies

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Immunology
• Immunogenetics

Background:

• Primary immunodeficiency (PID) encompasses a heterogeneous group of disorders affecting the immune system.
• Atopy and allergic diseases are common conditions that may present differently in immunocompromised individuals.
• Understanding the comorbidity of allergic conditions in PID is crucial for comprehensive patient management.

Purpose of the Study:

• To determine and compare the prevalence of atopy and allergic diseases across various primary immunodeficiency (PID) patient groups.
• To investigate specific associations between PID types and allergic manifestations, including asthma.
• To provide evidence-based recommendations for the clinical evaluation of allergic diseases in PID patients.

Main Methods:

• A cohort of 318 pediatric patients (6 months to 18 years) diagnosed with primary immunodeficiency (PID) was studied.
• Data collection involved detailed patient and parental questionnaires on histories of asthma and allergic diseases.
• Statistical analyses were performed to compare the frequencies of allergic conditions among different PID subgroups.

Main Results:

• Antibody deficiency was the most prevalent PID type (82.4%), followed by combined immunodeficiency (10.4%).
• Patients with selective immunoglobulin (Ig)A deficiency reported significantly more instances of ever wheezing compared to IgG subclass deficiency.
• A higher frequency of current wheezing was observed in patients with antibody deficiency versus combined immunodeficiency.

Conclusions:

• Patients diagnosed with primary immunodeficiency (PID), especially antibody deficiency and selective IgA deficiency, exhibit a notable predisposition to atopy and allergic diseases.
• The findings underscore the importance of screening for asthma and allergic conditions in PID patients presenting with recurrent respiratory symptoms.
• Integrated care approaches are essential for managing the complex health needs of pediatric PID patients.