Primary immunodeficiency disorders / primary immune disorders / primary immunodeficiency
- By sahlhealth
- May 18, 2021
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Primary immunodeficiency disorders — also called primary immune disorders or primary immunodeficiency — weaken the immune system, allowing infections and other health problems to occur more easily.
Many people with primary immunodeficiency are born missing some of the body's immune defenses or with the immune system not working properly, which leaves them more susceptible to germs that can cause infections.
Some forms of primary immunodeficiency are so mild they can go unnoticed for years. Other types are severe enough that they're discovered soon after an affected baby is born.
Treatments can boost the immune system in many types of primary immunodeficiency disorders. Research is ongoing, leading to improved treatments and enhanced quality of life for people with the condition.
One of the most common signs of primary immunodeficiency is having infections that are more frequent, longer lasting or harder to treat than are the infections of someone with a normal immune system. You may also get infections that a person with a healthy immune system likely wouldn't get (opportunistic infections).
Signs and symptoms differ depending on the type of primary immunodeficiency disorder, and they vary from person to person.
Signs and symptoms of primary immunodeficiency can include:
Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
Inflammation and infection of internal organs
Blood disorders, such as low platelet counts or anemia
Digestive problems, such as cramping, loss of appetite, nausea and diarrhea
Delayed growth and development
Autoimmune disorders, such as lupus, rheumatoid arthritis or type 1 diabetes
Treatments for primary immunodeficiency involve preventing and treating infections, boosting the immune system, and treating the underlying cause of the immune problem. In some cases, primary immune disorders are linked to a serious illness, such as an autoimmune disorder or cancer, which also needs to be treated.
Treating infections. Infections require rapid and aggressive treatment with antibiotics. Treatment might require a longer course of antibiotics than is usually prescribed. Infections that don't respond may require hospitalization and intravenous (IV) antibiotics.
Preventing infections. Some people need long-term antibiotics to prevent respiratory infections and permanent damage to the lungs and ears. Children with primary immunodeficiency might not be able to have vaccines containing live viruses, such as oral polio and measles-mumps-rubella.
Treating symptoms. Medications such as ibuprofen (Advil, Motrin IB, others) for pain and fever, decongestants for sinus congestion, and expectorants to thin mucus in the airways might help relieve symptoms caused by infections.
Treatment to boost the immune system
Immunoglobulin therapy. Immunoglobulin consists of antibody proteins needed for the immune system to fight infections. It can either be injected into a vein through an IV line or inserted underneath the skin (subcutaneous infusion). IV treatment is needed every few weeks, and subcutaneous infusion is needed once or twice a week.
Interferon-gamma therapy. Interferons are naturally occurring substances that fight viruses and stimulate immune system cells. Interferon-gamma is a manufactured (synthetic) substance given as an injection in the thigh or arm three times a week. It's used to treat chronic granulomatous disease, one form of primary immunodeficiency.
Growth factors. When the immune deficiency is caused by a lack of certain white blood cells, growth factor therapy can help increase the levels of immune-strengthening white blood cells.
Stem cell transplantation
Stem cell transplantation offers a permanent cure for several forms of life-threatening immunodeficiency. Normal stem cells are transferred to the person with immunodeficiency, giving him or her a normally functioning immune system. Stem cells can be harvested through bone marrow, or they can be obtained from the placenta at birth (cord blood banking).
The stem cell donor — usually a parent or other close relative — must have body tissues that are a close biological match to those of the person with primary immunodeficiency. Even with a good match, however, stem cell transplants don't always work.
The treatment often requires that functioning immune cells be destroyed using chemotherapy or radiation before the transplants, leaving the transplant recipient temporarily even more vulnerable to infection.