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[Ear, nose, and throat manifestations in patients with primary immunodeficiencies]
G Galicia1, M A Betancourt, L E Canales
1Departamento de otorrinolaringología, Instituto Nacional de Enfermedades Respiratorias (INER), México, DF.
Insights
Recurrent ear and sinus infections in children may indicate primary immunodeficiency. Early immunology evaluation is crucial for timely diagnosis and treatment of these congenital conditions.
Area of Science:
- Immunology
- Otolaryngology
- Pediatrics
Background:
- Primary immunodeficiencies (PIDs) are a group of congenital disorders affecting the immune system.
- Recurrent sinopulmonary infections are common manifestations of PIDs.
- Timely diagnosis is essential for effective management and prevention of complications.
Observation:
- This study reviewed 10 patients diagnosed with PIDs based on chronic, difficult-to-control recurrent otolaryngologic symptoms.
- Patients included six males and four females, aged 4 to 36 years.
- Identified PIDs included hyper-IgM, IgG deficiency, common variable immunodeficiency, C3 complement deficiency, and IgA deficiency with atopy.
Findings:
- Chronic or recurrent sinusitis and otitis media can be the sole presenting symptoms of PIDs.
- Infectious symptoms in the ear, nose, and throat warrant consideration of underlying immunodeficiency.
- The study identified various types of PIDs presenting with these symptoms.
Implications:
- Establishing a diagnostic flowchart for PIDs based on otolaryngologic manifestations is proposed.
- Recommended immunological evaluation includes complete blood count with differential, immunoglobulin levels, IgG subclasses, complement components (C3, C4), and antibody responses to protein and polysaccharide antigens.
- Early detection through focused evaluation can significantly improve patient outcomes for primary immunodeficiencies.
Objective:
To determine the flowgram for the timely diagnosis of the immunodeficiencies congenital primary, based on the demonstrations otorrinolaringol recurrent chronicles to difficult control, with or without associated systemic diseases.
Material And Method:
Retrospective study, descriptive and observational that included patient with diagnostic of primary known immunodeficiency. They were checked the clinical files to know their evolution and medical treatment-surgical.
Results:
They were found 10 patient with diagnostic of some primary immunodeficiency; this was made based on the infectious symptoms otolaryngal chronic recurrent to difficult control; they were six men and four women between the four and 36 years old. They were found the following immunodeficiencies: one of hyper-IgM, three by IgG, variable common three, a deficit with C3 of the complement, two of IgA more atopia.
Conclusions:
The chronicle sinusitis or recurrent and the otitis mean chronicle or recurrent can be the only demonstrations of a patient with primary immunodeficiency. The immunology evaluation must include, at least: hematic biometric completes with differential, seric levels of immunoglobulins, the same as subclass of IgG, C4 and C3 of the complement, response to immunization with proteins (diphtheria and tetanus), and polysaccharide antigens (pneumovax).