What does secondary immunodeficiency mean? Primary immunodeficiencies

Secondary immunodeficiency- symptoms and treatment

What is secondary immunodeficiency? We will discuss the causes of occurrence, diagnosis and treatment methods in the article by Dr. E. Yu. Bychkova, an immunologist with 21 years of experience.

Publication date September 19, 2019Updated October 04, 2019

Definition of disease. Causes of the disease

Secondary immunodeficiency is a pathological condition of the body in which a defect in one or more immune response mechanisms leads to a disruption of the immune system as a whole. It develops against the background of the underlying disease.

Secondary immunodeficiency develops in people over 16 years of age with an initially normally functioning immune system. Usually its appearance is associated with exposure to the environment or some other factors, but in many of the patients a genetic predisposition to the formation of immune problems can be identified.

An immunologically healthy body is able to control and prevent the development of infections and tumor processes, that is, to exercise immunological control of the internal environment. With the development of secondary immunodeficiency, the main “marker” of the problem becomes the development of infections caused by opportunistic agents (viruses, bacteria and fungi), and the activation of infections that usually do not occur in people with healthy immunity. Therefore, the main signs of secondary immunodeficiency are relapses and exacerbations of infections - acute, subacute and chronic.

Reasons for the development of secondary immunodeficiency states:

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of secondary immunodeficiency

Clinical manifestations of secondary immunodeficiency are varied. Very often, the symptoms of the underlying disease that led to the formation of immunodeficiency come to the fore. But the main manifestations of problems with immunity, which indicate the need for an immunological examination, are still present. These include:

• frequent colds - more than six times a year in children and more than four times a year in adults;
• the duration of each episode of the infectious-inflammatory process is more than two weeks;
• recurrence of infections that usually do not occur in people with healthy immune systems (herpes, infections caused by Candida fungi);
• recurrence of bacterial infections (furunculosis, hidradenitis, gynecological and ENT diseases);
• a slight increase in temperature of unknown origin, that is, possible causes such as tuberculosis and cancer are excluded;
• recurrence of lymphadenitis and lymphadenopathy (inflammation of the lymph nodes);
• asthenic syndrome - weakness, fatigue, decreased performance, feeling exhausted after 8 hours of sleep;
• chronic ulcers and non-healing wounds.

All chronic infections and inflammations occur against the background of weakened immune defense. Therefore, any chronic infection will indicate a failure of the immune system, which cannot cope with the disease during an acute inflammatory process.

It should be remembered that the optimal option for immune protection during an acute infection should result in recovery on average within 2-4 weeks from the onset of the disease.

Pathogenesis of secondary immunodeficiency

During life, the body is exposed to various damaging factors that cause secondary immunodeficiency. They lead to inhibition of cellular immune responses, a decrease in leukocytes and interferons - immune system proteins that are produced by leukocytes and immune cells and block the spread of the virus. As a result, chronic infectious and inflammatory processes appear, often relapsing.

Some trace elements can regulate the functioning of the immune system, for example, zinc, iodine, lithium, copper, cobalt, chromium, molybdenum, selenium, manganese and iron. Their lack aggravates immune dysfunction.

Lack of vitamins, imbalance of macro- and microelements caused by an unbalanced diet lead to disruption of the cellular immune system: the response of lymphocytes to mitogens (substances that stimulate T cells) is reduced, atrophy of lymphoid tissue is observed, the function of neutrophils (blood cells that suppress harmful substances) is impaired ) .

The mechanism of development of secondary immunodeficiency can be most clearly demonstrated using the example of viruses of the herpes family. Many viruses (herpes simplex viruses of the first and second types, cytomegalovirus, Epstein-Barr virus, rhinoviruses, enteroviruses) are constantly present in the cells of the body. Periodically activated under the influence of stress, unbalanced nutrition, concomitant pathology or immunosuppressive therapy, they contribute to the appearance of various clinical manifestations.

Tumors that arise in the body with weakened immune defenses deplete the immune system as they grow, and the treatment (surgery, radiation and chemotherapy) also aggravates the resulting immunodeficiency. In this case, the cellular component of immunity suffers:

All serious diseases also lead to the development of immune deficiency. For example, in diabetes mellitus, chemotaxis (the movement of microorganisms in response to a chemical) and phagocytic activity of neutrophils (the number of cells involved in the capture of viruses and bacteria) are inhibited, protection against bacterial infections is impaired, as a result of which skin pyoderma (purulent diseases) and abscesses develop.

The body responds to stress by releasing active substances such as catecholamines and glucocorticoids, which have an important modulating effect on the functioning of immune system cells. Under their influence, pro-inflammatory cytokines are released, processes are launched aimed at combating a possible infectious agent. With chronic stress, due to the prolonged influence of glucocorticoids on cells of the immune system, the level of immunoglobulins and the activity of phagocytosis decreases. As a result, the process of apoptosis and cell damage is triggered during oxidation - programmed death in cells of the immune system. If there was no excess load and the body had enough rest, then the functioning of the immune system returns to normal.

Classification and stages of development of secondary immunodeficiency

The form of secondary immunodeficiency can be:

There are two types of secondary immunodeficiency based on duration:

Based on a study of the immune status, secondary immunodeficiency is distinguished by the location of the main defect:

• 1. combined deficiency - changes affect several parts of the immune defense;
• 2. T-cell deficiency;
• 3. predominantly B-cell deficiency;
• 4. defect of natural killer cells;
• 5. deficiency of macrophages and granulocytes;
• 6. deficiency of the complement system;
• 7. platelet system deficiency;
• 8. deficiency of the interferon system.

It is almost impossible to establish the localization of damage to the immune system, based only on symptoms, without laboratory testing of immune defense indicators, since a similar clinical picture can be observed with different types of secondary deficiency. For example, a person may be prone to viral infections both with T-cell deficiency and with a deficiency of the interferon system.

Separately, it should be said about physiological immunodeficiency in pregnant women. It is reversibly formed in a woman’s body for the growth and development of the fetus and does not require immunocorrection.

Complications of secondary immunodeficiency

Secondary immunodeficiency, developing against the background of an underlying infectious and/or inflammatory disease, becomes the cause of severe life-threatening conditions. The lack of timely correction of this state of immunity closes the pathological circle and worsens the course of the underlying disease.

The most common complications of secondary immunodeficiency are severe infectious diseases: sepsis, abscess and phlegmon. Their main manifestations are high fever and signs of inflammation. Pneumonia causes shortness of breath, cough, and chest pain. Sepsis develops when an infection enters the bloodstream and is accompanied by a systemic inflammatory response, multiple organ failure and is a life-threatening condition. With abscesses and phlegmon, there is a focus of purulent inflammation in the body with severe pain, swelling, and hyperemia (redness).

Taking into account the great heterogeneity of these diseases, the prognosis and possible complications should be determined individually, based on the course and severity of the underlying disease, against which secondary immunodeficiency arose.

Diagnosis of secondary immunodeficiency

The diagnosis of secondary immunodeficiency is made based on history, physical examination, and testing of immune system function.

To prescribe effective measures to correct immunity, it is very important to identify the factors that contributed to the development of immunodeficiency. Therefore, for a consultation with an immunologist, the patient should bring all the examinations he has, and the doctor will ask in great detail about the diseases suffered, the treatment performed, operations and the patient’s lifestyle.

If secondary immunodeficiency is suspected, the doctor prescribes a blood test and an immunogram - immunological tests that evaluate the quantitative and qualitative characteristics of the components of the immune system.

The immunogram consists of several blocks:

Secondary immunodeficiency can be indicated by both decreased and increased immunogram values.

Since the immune system works according to a system of modules, in the early stages, a violation of immunity may be accompanied, for example, by an increase in T-link indicators or a deficiency of interferon status indicators. This picture is observed at the beginning of the chronic course of herpetic infections. At later stages of secondary immunodeficiency, a decrease in indicators can already affect both links, which can often be seen in the immunograms of patients with common cancers.

If an imbalance of key nutrients (vitamins, microelements, etc.) is suspected, an immunologist may prescribe tests:

In his conclusion, the immunologist can diagnose “secondary immunodeficiency” as either the main diagnosis or a concomitant one. It all depends on the clinical picture.

Treatment of secondary immunodeficiency

Treatment of a patient with secondary immunodeficiency is carried out together with a doctor who supervises the patient regarding the underlying disease. The task of the immunologist is to select immunocorrective therapy. “Immune correction” in this case means treatment aimed at restoring the body’s weakened immune defense, correcting the imbalance of its components and immune reactions, weakening pathological immune processes and suppressing autoimmune reactions.

Treatment of secondary immunodeficiency begins with identifying and eliminating the cause of its occurrence. For example, in case of a disorder of immunity caused by an infectious-inflammatory process, sanitation (cleansing) of foci of chronic inflammation is required.

If secondary immunodeficiency occurs as a result of vitamin and mineral deficiency, then complexes containing deficient components are prescribed. For example, with the aging of the thymus gland and depletion of the lymph nodes, vitamins B6 are prescribed. During exacerbation or onset of autoimmune and lymphoproliferative diseases, vitamins E are indicated.

Important minerals for the immune system are zinc, iodine, lithium, copper, cobalt, chromium, molybdenum, selenium, manganese, iron. These trace elements are necessary for the activation of enzymes involved in immune reactions. For example, zinc prevents the death of immune system cells.

Sometimes the immune system cannot cope with the pathological process due to a deficiency of any protective factors (cells and cytokines). In such cases, the immunologist prescribes immunostimulating drugs to speed up recovery and stimulate the immune system.

Taking immunomodulators for acute infectious inflammation allows you to:

• reduce the depth of damage in inflamed tissues;
• reduce the time of rehabilitation and recovery;
• reduce the risk of fatal complications in severe cases;
• prevent chronic disease and the formation of resistant strains of infectious agents.

In chronic infectious inflammation, immunomodulators contribute to:

• a significant reduction in symptoms of the disease or complete recovery;
• a significant increase in the period of remission between exacerbations of recurrent infection.

The degree of effectiveness of immunocorrection is influenced by the frequency of its use and the stage of the disease. The duration of action of immunomodulators depends on the nature of the drug, indicators of immune status and the type of disease that caused secondary immunodeficiency.

Elimination of a deficiency in one part of the immune system can lead to compensation of another part, since the immune system operates on the principle of interconnected modules.

Either one immunomodulator or several, that is, a combination of them, can be prescribed. Under combined immunocorrection understand the sequential or simultaneous use of several modulators with different mechanisms of action. Today, a large number of immunomodulatory drugs with different mechanisms of action are known.

Indications for combination immunotherapy are:

• chronicity of the underlying pathological process (when the disease lasts more than three months);
• frequent relapses of the underlying disease (more than four times a year);
• the presence of complications of the main pathological process;
• severe intoxication syndrome;
• impaired metabolism;
• unsuccessful immunocorrection with one drug for a month;
• damage to several links (phagocytosis, T- and B-links of immunity);
• the need for multidirectional effects on the links of immunity - stimulation of one link and inhibition of another.

IMPORTANT: You cannot prescribe immunocorrectors on your own, since their uncontrolled use can only provoke the development of secondary immunodeficiency.

Forecast. Prevention

In secondary immunodeficiency, immune system disorders are less pronounced than in primary immunodeficiency. In most cases, several factors are identified that suppress the immune response.

As a rule, the prognosis of secondary immunodeficiency is determined by the severity of the disease that caused it. For example, immunodeficiency caused by a lack of vitamins or a violation of the work-rest regime is much easier to compensate for than immunodeficiency caused by a tumor process, diabetes mellitus or HIV infection.

In a child's body, individual parts of the immune system are still immature. T-lymphocytes are just beginning to “get acquainted” with various infectious agents, so the child often suffers from various acute respiratory viral infections. Over time, “memory cells” accumulate. As people grow older, a wide “repertoire” of T-lymphocytes develops that can recognize and quickly trigger an immune response, and therefore the incidence of disease decreases.

As the body ages, so does the immune system. For example, due to age-related changes, fewer T cells participate in the response to new antigens, cooperation between cells of the immune system worsens, and the efficiency of phagocytosis (the absorption of viruses and dead cells) decreases. Therefore, many infectious and inflammatory diseases become much more severe with age and cause complications more often.

Primary prevention of secondary immunodeficiency consists of maintaining a healthy lifestyle, a balanced diet, and quitting smoking. All this helps prevent the development of various diseases.

Secondary prevention can be carried out with timely treatment of infectious and general somatic diseases.

People with secondary immunodeficiency need “special conditions” that will prevent the worsening of the immune disorder.

Immunodeficiency is a violation of the protective functions of the human body, due to a weakened immune response to pathogens of various natures. Science has described a whole range of species of conditions of this kind. This group of diseases is characterized by an increased frequency and severity of infectious diseases. Malfunctions of the immune system in this case are associated with changes in the quantitative or qualitative characteristics of its individual components.

Properties of immunity

The immune system plays a vital role in the normal functioning of the body, as it is designed to detect and destroy antigens that can either penetrate from the external environment (infectious) or be a consequence of tumor growth of one’s own cells (endogenous). The protective function is primarily provided by innate factors such as phagocytosis and the complement system. Acquired and cellular responses are responsible for the body's adaptive response. The connection of the entire system occurs through special substances - cytokines.

Depending on the cause of occurrence, immune disorders are divided into primary and secondary immunodeficiencies.

What is primary immunodeficiency

Primary immunodeficiencies (PIDs) are disorders of the immune response caused by genetic defects. In most cases, they are inherited and are congenital pathologies. PIDs are most often discovered early in life, but sometimes they are not diagnosed until adolescence or even adulthood.

PID is a group of congenital diseases that vary in clinical manifestations. The International Classification of Diseases includes 36 described and sufficiently studied primary immunodeficiency conditions, but according to the medical literature there are about 80 of them. The fact is that not all diseases have identified the responsible genes.

The gene composition of the X chromosome alone is characterized by at least six different immunodeficiencies, and therefore the incidence of such diseases in boys is an order of magnitude higher than in girls. There is an assumption that the development of congenital immunodeficiency may be etiologically influenced by intrauterine infection, but this statement has not yet been scientifically confirmed.

Clinical picture

The clinical manifestations of primary immunodeficiencies are as varied as these conditions themselves, but there is one common symptom - hypertrophied infectious (bacterial) syndrome.

Primary immunodeficiencies, like secondary ones, are manifested by the tendency of patients to frequent recurrent diseases of infectious etiology, which can be caused by atypical pathogens.

These diseases most often affect the bronchopulmonary system and ENT organs of humans. The mucous membranes and skin are also often affected, which can manifest as abscesses and sepsis. Bacterial pathogens cause bronchitis and sinusitis. People suffering from immunodeficiency often experience early baldness and eczema, and sometimes allergic reactions. Autoimmune disorders and a tendency to malignant neoplasms are also common. Immunodeficiency in children almost always causes delayed mental and physical development.

Mechanism of development of primary immunodeficiencies

Classification of diseases according to the mechanism of their development is the most informative in the case of studying immunodeficiency states.

Doctors divide all diseases of an immune nature into 4 main groups:

Humoral or B-cell, which include Bruton's syndrome (agammaglobulinemia linked to the X chromosome), IgA or IgG deficiency, excess IgM with general immunoglobulin deficiency, simple variable immunodeficiency, transient hypogammaglobulinemia of newborns and a number of other diseases associated with humoral immunity.

T-cell primary immunodeficiencies, which are often called combined, because with the first disorders, humoral immunity is always impaired, for example, hypoplasia (DiGeorge syndrome) or dysplasia (T-lymphopenia) of the thymus.

Immunodeficiencies caused by defects in phagocytosis.

Immunodeficiencies caused by malfunctions

Susceptibility to infections

Since the cause of immunodeficiency may be a violation of various links
immune system, then the susceptibility to infectious agents will not be the same for each specific case. For example, with humoral diseases, the patient is prone to infections caused by streptococci, staphylococci, and these microorganisms often show resistance to antibacterial drugs. In combined forms of immunodeficiency, viruses, such as herpes or fungi, which are mainly represented by candidiasis, can join bacteria. The phagocytic form is characterized mainly by the same staphylococci and gram-negative bacteria.

Prevalence of primary immunodeficiencies

Inherited immunodeficiencies are quite rare human diseases. The incidence of immune disorders of this kind must be assessed in relation to each specific disease, since their prevalence is not the same.

On average, only one newborn in fifty thousand will suffer from congenital hereditary immunodeficiency. The most common disease in this group is selective IgA deficiency. Congenital immunodeficiency of this type occurs on average in one in a thousand newborns. Moreover, 70% of all cases of IgA deficiency relate to complete deficiency of this component. At the same time, some rarer human diseases of an immune nature that are inherited can be distributed in a ratio of 1:1000000.

If we consider the incidence of PID diseases depending on the mechanism, a very interesting picture emerges. B-cell primary immunodeficiencies, or, as they are commonly called, disorders of antibody formation, are more common than others and account for 50-60% of all cases. At the same time, T-cell and phagocytic forms are diagnosed in 10-30% of patients each. The rarest are diseases of the immune system caused by complement defects - 1-6%.

It should also be noted that data on the incidence of PID vary greatly in different countries, which may be due to the genetic predisposition of a particular national group to certain DNA mutations.

Diagnosis of immunodeficiencies

Primary immunodeficiency in children is most often determined untimely due to
with the fact that it is quite difficult to make such a diagnosis at the level of a local pediatrician.

This usually leads to a delayed start of treatment and an unfavorable prognosis for therapy. If the doctor, based on the clinical picture of the disease and the results of general tests, has suggested an immunodeficiency state, the first thing he should do is refer the child for a consultation with an immunologist.
In Europe, there is an Association of Immunologists that deals with the study and development of methods for treating this type of disease, called the EIS (European Society for Immunodeficiency). They have created and constantly updated a database of PID diseases and approved a diagnostic algorithm for a fairly quick diagnosis.

Diagnosis begins with collecting an anamnesis of the disease. Particular attention should be paid to the genealogical aspect, since most congenital immunodeficiencies are hereditary. Next, after a physical examination and obtaining data from general clinical studies, a preliminary diagnosis is made. In the future, in order to confirm or refute the doctor’s assumption, the patient must undergo a thorough examination by specialists such as a geneticist and an immunologist. Only after all the above-described manipulations can we talk about making a final diagnosis.

Laboratory research

If during diagnosis a suspicion of primary immunodeficiency syndrome arises, the following laboratory tests must be performed:

Establishment of a detailed blood count (particular attention is paid to the number of lymphocytes);

Determination of immunoglobulin content in blood serum;

Quantitative counting of B- and T-lymphocytes.

Additional Research

In addition to the laboratory diagnostic tests already mentioned above, individual additional tests will be prescribed in each specific case. There are risk groups that need to be tested for HIV infection or genetic disorders. The doctor also foresees the possibility that there is a human immunodeficiency of 3 or 4 types, in which he will insist on a detailed study of the patient’s phagocytosis by performing a test with the tetrazoline blue indicator and checking the component composition of the complement system.

Treatment of PID

Obviously, the necessary therapy will depend primarily on the immune disease itself, but, unfortunately, the congenital form cannot be eliminated completely, which cannot be said about acquired immunodeficiency. Based on modern medical developments, scientists are trying to find the ability to eliminate the cause at the genetic level. While their attempts have not been successful, it can be stated that immunodeficiency is an incurable condition. Let's consider the principles of the therapy used.

Replacement therapy

Treatment of immunodeficiency usually comes down to replacement therapy. As mentioned earlier, the patient’s body is not able to independently produce certain components of the immune system, or their quality is significantly lower than necessary. Therapy will consist of medicinal administration of antibodies or immunoglobulins, the natural production of which is impaired. Most often, medications are administered intravenously, but sometimes the subcutaneous route is also possible, to make the life of the patient easier, who in this case does not have to visit a medical facility once again.

The principle of replacement often allows patients to lead an almost normal lifestyle: study, work and relax. Of course, immunity weakened by the disease, humoral and cellular factors and the constant need to administer expensive drugs will not allow the patient to completely relax, but this is still better than life in a pressure chamber.

and prevention

Considering that any bacterial or viral infection that is insignificant for a healthy person can be lethal for a patient with a disease of the primary immunodeficiency group, it is necessary to carry out proper prevention. This is where antibacterial, antifungal and antiviral medications come into play. should be done specifically for preventive measures, because a weakened immune system may not allow for quality treatment.

In addition, it should be remembered that such patients are prone to allergic, autoimmune and, even worse, tumor conditions. All this without full medical control may not allow a person to lead a full life.

Transplantation

When specialists decide that there is no other option for the patient other than surgery, a bone marrow transplant may be performed. This procedure is associated with multiple risks to the life and health of the patient and in practice, even in the case of a successful outcome, it cannot always solve all the problems of a person suffering from an immune disorder. During such an operation, the entire recipient is replaced with the same one provided by the donor.

Primary immunodeficiencies are the most difficult problem of modern medicine, which, unfortunately, has not yet been completely solved. An unfavorable prognosis for diseases of this kind still prevails, and this is doubly sad considering the fact that children most often suffer from them. But nevertheless, many forms of immune deficiency are compatible with a full life, provided they are diagnosed in a timely manner and adequate therapy is used.

Immunodeficiencies - This is a weakened state of the human immune system, which ultimately leads to more frequent diseases of infectious diseases. With immunodeficiency, the infection is more severe than in people in a normal state. This disease in people with immunodeficiency is also more difficult to treat.

According to their origin, immunodeficiencies are divided into primary (that is hereditary ) And secondary (that is acquired ).

The main signs of immunodeficiency of both types are chronic infectious diseases. In such conditions, infections of the upper and lower respiratory tract, skin, ENT organs, etc. occur. The manifestation of diseases, their severity and types are determined depending on what type of immunodeficiency occurs in a person. Sometimes, due to immunodeficiency, a person develops allergic reactions And .

Primary immunodeficiency

Primary immunodeficiency is a disease of the immune system that is hereditary in nature. According to medical statistics, such a defect occurs in one child in ten thousand. Primary immunodeficiency is a disease that is transmitted to children from parents. There are many forms of this condition. Some of them can openly manifest themselves almost immediately after the birth of a child, while other forms of immunodeficiency do not make themselves felt for many years. In approximately 80% of cases, by the time primary immunodeficiency is diagnosed, the patient’s age does not exceed twenty years. About 70% of cases of primary immunodeficiency are diagnosed in males, since most syndromes are directly related to X chromosome .

In primary immunodeficiency, genetic defects are divided into several groups. At humoral immunodeficiencies the body does not produce sufficiently or ; at cellular immunodeficiencies lymphocytic immunodeficiency occurs; at phagocytosis defects bacteria cannot be fully captured ; at complement system defects There is an inferiority of proteins that destroy foreign cells. In addition, there are combined immunodeficiencies , as well as a number of other immunodeficiencies in which there are problems with the main links .

In most cases, primary immunodeficiencies are conditions that persist in a person throughout his life. However, many patients whose disease was diagnosed on time and adequately treated have a normal life expectancy.

Secondary immunodeficiency

Under secondary immunodeficiency the presence of acquired diseases of the immune system should be understood. In this case, as with primary immunodeficiencies, we are talking about too frequent attacks of infectious diseases due to weakened immunity. The best known example of this type of immunodeficiency is , which develops as a result . In addition, secondary immunodeficiencies manifest themselves under the influence of drugs, radiation, and certain chronic diseases. Secondary immunodeficiency can be observed in patients who consult a doctor with complaints of a variety of ailments.

In general, all actions that, one way or another, weaken a person’s immune system contribute to the development of secondary immunodeficiency.

In addition, this condition occurs with nutritional deficiencies, in which there is protein-calorie malnutrition , as well as the disadvantage vitamins And microelements . In this case, deficiency has a particularly detrimental effect on the human condition. , Selena , zinc . Also at risk for immunodeficiency are people with chronic metabolic disorders resulting from liver and kidney diseases. People who have undergone serious surgery or injury are also somewhat susceptible to developing immunodeficiency.

In secondary immunodeficiencies, it is important to detect bacterial infections as early as possible and take the necessary treatment.

How does immunodeficiency manifest?

The main and in some cases the only sign of immunodeficiency is a person’s predisposition to very frequent manifestations of infectious diseases. The state of immunodeficiency is characterized by the manifestation recurrent respiratory infections . However, in this case, doctors clearly distinguish between the manifestations of immunodeficiency and the so-called sickness of children, who often contract colds from their peers.

A more characteristic sign of immunodeficiency is the manifestation of a severe bacterial infection, which is recurrent in nature. As a rule, with its development, there is a periodic recurrence of sore throat, as well as infection of the upper respiratory tract. As a result, the patient develops chronic sinusitis , , otitis . Also a characteristic feature of the immunodeficiency state is the ease of development and subsequent progression of diseases. Thus, in patients with immunodeficiency, bronchitis very easily turns into pneumonia , appears and bronchiectasis .

In addition, such patients very often develop infections of the skin and mucous membranes of the body. So, the most characteristic states in this case are, periodontitis , , which is resistant to treatment. In addition, patients with immunodeficiency very often develop and baldness .

A typical manifestation of this condition may also be a number of disorders of the digestive system, for example, , malabsorption .

In more rare cases, hematological disorders are diagnosed in immunodeficiency, e.g. leukopenia , autoimmune hemolytic anemia and etc.

In some cases, neurological seizures may also occur: convulsions , , , . There is evidence of an increased incidence of development stomach cancer in such patients.

Diagnosis of immunodeficiency

In the process of diagnosing an immunodeficiency state, the doctor must pay close attention to the family history. So, it is quite possible that there are frequent autoimmune diseases , early mortality, early manifestation of malignant diseases. A similar diagnosis may also be indicated by an adverse reaction to vaccination . Carrying out radiation therapy certain areas of the body may also be a prerequisite for establishing such a diagnosis.

When examining a patient, the attending physician must pay attention to his appearance. As a rule, such a person looks especially sickly, has very pale skin, and constantly suffers from general malaise. A close examination of the skin is important, since immunodeficiency often causes vesicular rash , eczema .

In addition, the state of immunodeficiency is characterized by other manifestations: the occurrence eye inflammation ,chronic diseases of the ENT organs , swelling of the nostrils , chronic persistent cough .

To establish an accurate analysis, it is necessary to conduct a thorough examination of the patient. At the first stage of research, as a rule, a detailed blood test, screening tests, and determination of blood levels are prescribed. immunoglobulins . Other tests are also ordered to determine what type of infection a person has. If a patient is diagnosed with a recurrent infection, then examinations of such a patient are carried out regularly. If necessary, depending on the clinical situation, smears and subsequent microbiological studies are carried out.

Complications of immunodeficiencies

Serious infectious diseases should, first of all, be noted as frequently occurring complications of both types of immunodeficiencies. This sepsis , pneumonia , etc. In each specific case of manifestation of immunodeficiency, complications are determined individually.

AIDS virus

The human immunodeficiency virus is usually classified as a member of the retrovirus family. Today, doctors identify two types of this virus - HIV1 And HIV2 . Their fundamental differences lie in antigenic and structural features.

The human immunodeficiency virus is not resistant to environmental influences. It is destroyed by almost every substance with disinfectant properties. It is believed that this virus can be present in every biological fluid of the human body. But in the absence of blood in such a fluid, the amount of virus is not enough for infection to occur. Therefore, saliva, sweat, tears, and vomit are considered non-hazardous biological fluids. At the same time, in every liquid that is associated with , contains the virus in large quantities. That is why the risk of HIV transmission through sexual intercourse, as well as during breastfeeding, is very high. Therefore, the most dangerous body fluids from the point of view of HIV infection are blood , vaginal secretions , lymph , sperm , cerebrospinal , ascitic , pericardial liquids , breast milk .

The human immunodeficiency virus, once in the body, enters target cells, which are regulators in the process of the immune response. Gradually, the virus enters other cells, and the pathological process occurs in different systems and organs.

In the process of death of cells of the immune system, immunodeficiency appears, the symptoms of which are caused by a virus. Under its influence, a person develops diseases that are both infectious and non-infectious in nature.

The severity of the disease and the rate of its progression directly depends on the presence of infections, the genetic characteristics of the human body, his age, etc. The incubation period lasts from three weeks to three months.

After this, the stage of primary manifestations begins, at which the patient exhibits a variety of clinical symptoms and antibodies are actively produced. This stage can progress differently for different people. It is possible to have an asymptomatic course, the presence of an acute infection without secondary diseases, as well as an infection with secondary diseases.

As the virus enters the subclinical stage, immunodeficiency gradually increases, a person’s lymph nodes enlarge, while at the same time the rate of HIV reproduction slows down. This stage is quite long: it sometimes lasts up to twenty years, although its average duration is about six years. Later the patient develops acquired immunodeficiency syndrome .

Acquired immunodeficiency syndrome

The world first learned about acquired immunodeficiency syndrome in the mid-80s of the twentieth century. At that time, doctors discovered an unknown disease, which was characterized by the manifestation of immunodeficiency in adults. It was found that their immune deficiency manifested itself in adulthood. Consequently, this disease was then called acquired immune deficiency syndrome, or AIDS for short. Today, AIDS has spread to epidemic levels.

When a patient develops acquired immunodeficiency syndrome, his body cannot resist attacks from even relatively harmless microorganisms.

Diagnosis of HIV infection is made using special laboratory research methods. However, there are currently no drugs that effectively act on the AIDS virus.

Treatment is mainly aimed at overcoming secondary infections that develop as a result of immunodeficiency.

The doctors

Treatment of immunodeficiencies

The most important point for people diagnosed with any type of immunodeficiency is to adhere as much as possible to the principles of a healthy lifestyle and avoid infections. It is equally important to have regular dental checkups.

It is important for patients with immunodeficiency to be diagnosed in a timely manner fungal And bacterial infections , and carry out their subsequent adequate therapy.

There are conditions that require ongoing preventative treatment . If a person has a chest infection, then in this case it is advisable to treat with physiotherapy, as well as regular special physical exercises. Sometimes, as a preventative measure, it is necessary to take drugs with antiviral effects, for example , .

In most cases, therapy for immunodeficiency is carried out using intravenous or subcutaneous administration immunoglobulins . However, it should be noted that immunoglobulin treatment is contraindicated in patients with heart failure. Today, other types of treatment for immunodeficiency are also practiced, but some of them are still at the experimental development stage.

In the process of treating primary immunodeficiency, it is important to determine in each specific case how justified the use of liquid vaccines is. In all cases, it is important for patients who have been diagnosed with primary immunodeficiency not to drink alcohol or smoke.

Immunocorrection today is carried out using several methods. This includes bone marrow transplantation, the use of immunomodulators and immunoglobulins.

In the treatment of secondary immunodeficiency, general principles of care are used. This includes vaccination, infection control, and replacement therapy.

Prevention of immunodeficiencies

To prevent the manifestation of primary immunodeficiencies, it is necessary to identify probable carriers of defective genes in families that have a positive history. For certain pathologies, prenatal diagnosis is possible.

Due to the hereditary nature of primary immunodeficiencies, there are currently no preventive measures for this type of disease.

As a preventive measure to prevent secondary immunodeficiencies, it is important to avoid HIV infection. For this, it is very important to never allow unprotected sexual contact, to make sure that the medical instruments used are sterile, etc. The risk group for contracting HIV also includes drug addicts who, even with a single injection of a drug, risk contracting the virus.

List of sources

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• Khaitov R.M., Ignatoeva G.A., Sidorovich I.G. Immunology.- M.: Medicine. - 2000;
• Yarilin A.A. Fundamentals of immunology // M. Medicine, 1999;
• Petryaeva M.V., Chernyakhovskaya M.Yu. Formalization of knowledge about HIV/AIDS infection. Part 1. Vladivostok: Far Eastern Branch of the Russian Academy of Sciences. 2007;
• Pokrovsky V.V., Ermak T.N., Belyaeva V.V. HIV infection. Clinic, diagnosis, treatment. M.: GEOTAR-Media, 2003.