Immunodeficiencies Flashcards
Disorder with recurrent bacterial and entoroviral infections after 6 months due to decreased maternal IgG more common in boys
Bruton (X-linked) agammaglobulinemia
Findings include absent B cells in peripheral blood, decreased Ig of all classes; absent/scanty lymph nodes and tonsils
Bruton (X-linked) agammaglobulinemia
Caused by a defect in BTK (tyrosine kinase gene) leading to no B cell maturation and XLR
Bruton (X-linked) agammaglobulinemia
Most common primary immunodeficiency associated with celiac disease with unknown defect
Selective IgA deficiency
Disease which has increased susceptibility to giardiasis and anaphylaxis after receiving blood products
Selective IgA deficiency
Presents with airway and GI infections, autoimmune disese, atopy and anaphylaxis; majority of time asymptomatic
Selective IgA deficiency
Common variable immunodeficiency has a defect in what cell types
B-cells (defect in differentiation)
Disease that presents after age 2 and may be considerably delayed with increased risk of autoimmune disease, bronchiectasis, lymphoma, and sinopulmonary infections
Common variable immunodeficiency
Disease that presents with recurrent sinopulmonary infections and lab findings of decreased plasma cells and immunoglobulins
Common variable immunodeficiency
Alternative name for thymic aplasia
DiGeorge syndrome
Common defect in DiGeorge syndrome
22q11 deletion
22q11 deletion in DiGeorge syndrome leads to…
failure to develop 3rd and 4th pharyngeal pouches causing absent thymus and parathyroids
Common findings in DiGeorge syndrome
Decreased T-cells, PTH and Calcium
X-ray findings in DiGeorge syndrome
Absent thymic shadow
Hypocalcemia in DiGeorge syndrome causes…
Tetany
T-cell deficiency in DiGeorge syndrome leads to…
recurrent viral/fungal infections
Common abnormalities in DiGeorge syndrome are…
conotruncal abnormalities like tetralogy of Fallot or truncus arteriosus
Disease with decreased IFN-gamma and decreased Th1 response that is autosomal recessive
IL-12 receptor deficiency
Disease that presents with disseminated mycobacterial infections due to decreased Th1 response and low IFN-gamma
IL-12 receptor deficiency
Disease that presents after administration of BCG vaccine and has low IFN-gamma
IL-12 receptor deficiency
Presents with thymic, parathyroid and cardiac defects
DiGeorge syndrome
IL-12 receptor deficiency has what inheritance pattern
Autosomal recessive
Bruton agammaglobulinemia has what inheritance pattern
X-linked recessive
Disease with impaired recruitment of neutrophils to sites of infection
Autosomal dominant hyper-IgE syndrome
Alternate name for autosomal dominant hyper-IgE syndrome
Job syndrome
Defect in Job syndrome
Deficiency of Th17 cells
Cause of Th17 cell deficiency in Job syndrome
STAT3 mutation
What Ig is increased in Job syndrome
IgE
Lab findings in someone with coarse facies, retained primary teeth and cold staphylococcal abscess
Decreased IFN-gamma, increased IgE and eosinophils
Common presentation for Job syndrome
FATED: coarse Facies, cold staphylococcal Abscess, retained primary Teeth, increased IgE, Dermatologic problems
Job syndrome has what inheritance pattern
Autosomal dominant
Defect in chronic mucocutaneous candidiasis
T-cell dysfunction
Patient with absent cutaneous reaction to Candida antigens will have a defect in what cell type
T-cell
Patient with chronic skin and mucous membrane infections with T-cell dysfunction has what disease
Chronic mucocutaneous candidiasis
Patient presents with failure to thrive, chronic diarrhea and thrus with defective IL-2R gamma chain has what condition
Severe combined immunodeficiency
What is the most common defect in SCID
Defective IL-2R gamma chain
What is the inheritance patter in SCID
X-linked recessive if IL-2R
Autosomal recessive if adenosine deaminase deficieny
What cells are defective in SCID
T-cells fail to develop leading to B-cell dysfunction
Flow cytometry findings in SCID
T-cells
Xray findings in SCID
Absence of thymic shadow
Patient with absent thymic shadow on chest xray, absent germinal centers and no T-cells on flow cytometry is at risk for what type of infections
Recurrent viral, bacterial, fungal, protozoal infections and opportunistic infections like pneumocystis
What is the treatment for SCID
Avoid live vaccines, give antimicrobial prophylaxis and IVIG
What is the curative treatment for SCID
Bone marrow transplant
Patient with recurrent viral, bacterial, fungal, protozoal infections and opportunistic infections like pneumocystis has what disease
SCID
Defect in ataxia-telangiectasia
ATM gene
ATM gene defect in ataxia-telangiectasia leads to…
failure to repair DNA double stranded breaks leading to cell cycle arrest
Triad of ataxia-telangiectasia
Ataxia, spider angiomas, IgA deficiency
What are the AFP levels in ataxia-telangiectasia
Increased AFP levels
Ataxia-telangiectasia increases the risk of developing…
lymphoma and leukemia
Common findings in ataxia-telangiectasia include…
Increased AFP levels, decreased IgA, IgG and IgE, lymphopenia and cerebellar atrophy
Hyper-IgM syndrome defect
Defective CD40L on Th cells
Defective CD40L on Th cells in hyper-IgM syndrome defect leads to…
class switching defect
Hyper-IgM syndrome defect inheritance pattern
X-linked recessive
Individual with opportunistic Pneumocystis or Cryptosporidium infection or CMV has what type of defect
Defective CD40L on Th cells seen in hyper-IgM syndrome
Common findings in X-linked recessive disorder with defective CD40L on Th cells
Normal or increased IgM, markedly decreased IgG, IgA, and IgE with failure to make germinal centers
Defect in Wiskott-Aldrich syndrome
WASp gene mutation
Wiskott-Aldrich syndrome inheritance pattern
X-linked recessive
Thrombocytopenia, eczema, and recurrent pyogenic infections are seen in…
Wiskott-Aldrich syndrome
Wiskott-Aldrich syndrome increases the risk of…
autoimmune disease and malignancy
WASp gene defect in Wiskott-Aldrich syndrome leads to…
leukocytes and platelets unable to reorganize actin filament leading to defective antigen presentation
Common findings in Wiskott-Aldrich syndrome
Decreased to normal IgG, IgM
Increased IgE, IgA
Fewer and smaller platelets
Leukocyte adhesion deficiency (type I) inheritance pattern
Autosomal recessive
Leukocyte adhesion deficiency (type I) defect
Defective LFA-1 integrin (CD18) protein on phagocytes
Defective LFA-1 integrin (CD18) protein on phagocytes in Leukocyte adhesion deficiency (type I) leads to…
impaired chemotaxis and migration of phagocytes
Recurrent skin and mucosal bacterial infections with absent pus in infant with delayed separation of umbilical cord has a defect in…
LFA-1 integrin (CD18) protein on phagocyte
Leukocyte adhesion deficiency (type I) presentation
Recurrent skin and mucosal bacterial infections with absent pus in infant with delayed separation of umbilical cord and impaired wound healing
Common finding at infection site in baby with delayed separation of umbilical cord
Absence of neutrophils at infection site
Chediak-Higashi syndrome inheritance pattern
Autosomal recessive
Chediak-Higashi syndrome defect
Lysosomal trafficking regulator gene (LYST) defect
Lysosomal trafficking regulator gene (LYST) defect in Chediak-Higashi syndrome leads to…
microtubule dysfunction in phagosome-lysosome fusion
Failure to form phagolysosomes in patient with recurrent pyogenic staph and strep infections has what disease
Chediak-Higashi syndrome
Chediak-Higashi syndrome common findings
Recurrent pyogenic staph and strep infections, partial albinism, peripheral neuropathy, progressive neurodegeneration, infiltrative lymphohistiocytis and neutropenia
Individual with giant granules in granulocytes and platelets, pancytopenia and mild coagulation defects with failure to form phagolysosomes has a defect in…
lysosomal trafficking regulator gene (LYST)
Chronic granulomatous disease (CGD) defect
NADPH oxidase defect
NADPH oxidase defect in CGD leads to…
decreased ROS and respiratory burst in neutrophils
CGD most common inheritance pattern
X-linked recessive
CGD patients are susceptible to what type of organisms
Catalase positive
Significance of catalase positive organisms in CGD
Catalase positive organisms can use H2O2 and prevent formation of ROS
CGD flow cytometry test findings
Abnormal dihydrorhodamine test with decreased green fluorescence
Nitroblue tetrazolium dye reduction test results…
Remains colorless - positive for CGD
Turns blue - normal NADPH oxidase
Catalase positive organisms
S aureus, P cepacia, S marcescens, Nocardia, Apergillus, Candida
MPO deficiency defect
Defective conversion of H2O2 to Hypochloride
MPO deficiency NBT results
Normal NBT
MPO deficieny increases risk of what infections
Candida infections