Screening for primary immune deficiency among patients with bronchiectasis
Mylène Dufrénoy1, Luminita Luca1, Vanessa Bironneau2
1Department of Internal Medicine, Poitiers University Hospital, 2, rue de la Milétrie, 86000 Poitiers, France.
Primary immune deficiency (PID) is often underscreened in bronchiectasis patients. Pneumologists should consider serum immunoglobulin and protein electrophoresis assays for better PID diagnosis and management.
Area of Science:
- Pulmonology
- Immunology
Background:
- Bronchiectasis is a chronic lung condition often associated with increased susceptibility to infections.
- Primary Immune Deficiency (PID) can present with or exacerbate bronchiectasis, necessitating appropriate screening.
Purpose of the Study:
- To evaluate the frequency and methods of PID screening in clinical practice among patients with bronchiectasis.
- To identify factors associated with PID screening and outcomes like recurrent infections.
Main Methods:
- Retrospective analysis of 133 patients with bronchiectasis hospitalized between 2013-2020.
- Assessment of serum immunoglobulin (Ig) assay and serum protein electrophoresis (SPE) utilization.
- Analysis of factors associated with PID diagnosis and antibiotic courses.
Main Results:
- Only 43% of patients received both SPE and Ig assays; 23% received neither.
- Asthma was significantly associated with higher rates of SPE+Ig assay.
- Four patients were newly diagnosed with PID, three with IgG subclass deficiency.
Conclusions:
- Primary immune deficiency is under-screened in patients with bronchiectasis by pulmonologists.
- Combined SPE, Ig assay, and IgG subclass assay is recommended for accurate PID detection.
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