Immunocompromised Patients Flashcards
What is meant by immunocompromised?
The immune system is unable to respond appropriately and effectivly to infetious microorganisms
Defect in 1 or more components of immune system
What are the main reasons to be immunocompromised?
Primary (intrinsic gene defects)
Secondary (aquired)
Whate are the primary (congenital) caused of immincompromisation?
Gene defect
Eg, missing protein
Missing cell
Non functioing components
What are the seconary (aquired) causes of being immunocompromised?
Underlying disease or treatment causing ;
- decrased production/ function immune components
- increased catabolism of immune components
What type of infections would cause you to suspect immunodeficiency?
SPURs
Severe (lifethreatening)
Persistant (not responding as should do)
Unusual (deep site of infection)
Recurrent
What are some early warning signs of PIDs?
Multiple ear/ sinus infections Failure of ndevelopment/ weight loss Reccurent need for IV abiotics Persistant thrush/ fungal infections Infections from normally harmless bacteria Family history of PID
What parts of the immune system can be effected by immunodeficiency disease?
Antibodies
T Cells (normally mean B cells affected too)
Phagocytes
What are the common abtibody deficiency diseases?
Common variable Immunodeficiency (CVID)
IgG (IgG2)
X-linked agammaglobulinaemia (Bruton’s disease)
What is CVID?
Most common that needs treatment
-low levels of antibodies
What is IgG deficiency?
Dont make enogh IgG protein
Most common but don’t need treatment
What is Bruton’s disease?
Absence of enxyme needed to produce B cells
No B cells produced= fewer antibodies
What are common deficiencies affecting T cells?
Severe combined immunodeficiency (SCID)
Di George syndrome
What is SCID?
Missing a recptor that prevent T cells from developing and maturing
Due to lack of T cells B cells cannot be produced (need cd4 activation)
What is Di George syndrome?
Partial/ full loss thymus
Meaning T cells can’t fully mature
Present with cardiac abnormalities
What are common imummodeficiency diseases caused by phacocytic defects?
Chronic granulomatous disease (CGD)
What is CGD?
Lack of enzyme needed for respiratory burst
Can’t kill microorganism only phagocyse it
How does age of onset of PID link to type?
Less than 6 months old - Tcell or Phagocyte
6months to 5 years - Bcell/antibody or Phagocyte
Over 5 years old- Bcell/antibody/ complement or secondary immunodeficiency
What does the type of microorganism suggest about the type of PID?
Phagocyte defects= Bacteria & fungi
Antibody deficiency= Bacteria
T cell deficiency=Bacteria, viral & fungi
Sites of infection for Phagocytic PID?
Skin/ mucosal membranes
Deep seated
Invasive fungal
Sites of infection for Antibody deficiency diseases?
Respiatory Joints GI Cancers Autoimmue
Sites of infection for T cell deficient PID?
Deep skin tissue
Opportunistic
Failure to thrive
Death if not treated
What is the main treatment for PIDs?
Immunoglobulin replacement therapy (IRT)
Blood from many helathy induviduals taken and IgG isolated, then given to patient
Will protect patient against any vaccines/ micobes the donars have come across
What are common caused of secondary immune deficiencies?
Deceased production of immune compponents
Incrrased loss of immune compenents
What causes decreased production of immune components?
Malnutrition Infection (HIV) Liver diseases Haematologial malignancies Treatments Splenectomy
Why are the elderly more likely to be malnourished?
Mental health (forgetting to eat)
Immobility
Social factors
What causes increased loss of immune components?
Protein losing conditions (reduced Albumin shows this)
Burns
What is Aspergillus?
Type of mould (fungus) that most of us breath in spores for on a day to day basis
Why does Aspergillous cause infection in the immunosurpressed?
Due to weakend immune system, reduced no cells to fight infection
Develop lung diseases
What does Varicella Zoster cause?
Chickenpox
Shingles in adults
How does Varicella-zooster manifect in the imunocomptetant?
Mild
Itchy rash
Malaise
Slight fever
How does Varicella-zoster infection present in immunocompromised pateints?
Can develop visceral dissemination (infection of internal organs)
Leading to; pneumonia, hepatitis, DIC
Atypical rash with more lesions
Lesions continue developing after 7 days
Overall illness lasts longer
