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Overview of secondary immunodeficiency
Katherine E Herman1, Katherine L Tuttle1
1From the Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York; and.
Secondary immunodeficiencies and immune dysregulation states (SID) are acquired immune impairments. Management involves addressing the cause, and if permanent, considering prophylaxis and immunoglobulin replacement.
Area of Science:
- Immunology
- Clinical Medicine
- Pathology
Background:
- Inborn errors of immunity (IEI) are inherited immune disorders.
- Secondary immunodeficiencies and immune dysregulation states (SID) are acquired immune impairments.
- SID can arise from comorbidities, medications, and iatrogenic factors.
Purpose of the Study:
- To differentiate between IEI and SID.
- To outline the causes and management of SID.
- To emphasize the importance of thorough evaluation for SID.
Main Methods:
- Review of existing literature on SID.
- Analysis of causes including medical comorbidities, medications, and iatrogenic factors.
- Discussion of diagnostic approaches including case history, medication review, and laboratory evaluation.
Main Results:
- SID encompasses a broad range of acquired immune impairments.
- Common causes include malnutrition, malignancy, immunosuppressive drugs, and surgical procedures.
- Distinguishing SID from underlying IEI is crucial for accurate diagnosis and treatment.
Conclusions:
- SID management requires addressing the underlying condition or removing the offending agent.
- Permanent SID may necessitate antibiotic prophylaxis, immunization, and immunoglobulin replacement.
- Comprehensive assessment is vital for effective SID management.
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