Immunodeficiencies Flashcards
Most severe antibody deficiency syndrome
Agammaglobulinemia
Only antibody deficiency in which B cells are few or absent <2%
Agammaglobulinemia
The commonest form of agammaglobulinemia
X LA
X linked agammaglobulinemia involves mutation in
Bruton tyrosine kinase gene
Btk gene
Noted after 6 months of age when maternal antibodies are depleted
Agammaglobulinemia
Agammaglobulinemia is failure of
b cell precursors PRO-B and PRE-B cells to develop into mature B cells
Profound defect in B lymphocyte development
Agammaglobulinemia
Streptococcus Pneumococcus Staphylococci Poliovirus Cocksakie virus
Predisposed in Bruton’s Agammaglobulinemia
Male
Deficient tyrosine kinase
No or small tonsil Absent B cell Absent plasma cell Absent Igs Absent antibody formation
X linked Agammaglobulinemia
Tx for Agammaglobulinemia
IVIg
Most common well defined primary immunodeficiency
Selective IgA deficiency
1:300 Abnormal switch defect Recurrent ear, sinus, lung infections Allergy, autoimmune diseases (DM, RA) Malignancy
Healthy
Selective IgA Deficiency
Selective IgA Deficiency Dx
Tx:
IgA <10 mg/dl (serum and secretory)
IgG, IgM, IgE Normal
Antibiotic
Impaired differentiation of naive B lymphocytes to IgA producing cells
Selective IgA deficiency
Selective IgA deficiency has weakened
mucosal defenses
(respiratory, GI, urogenital)
saliva, sweat, urine, secretion
Infancy with onset of distinct neonatal rash
Furunculosis, staph, pneumonia, cadidiasis
Hyper IgE syndrome HERIS
Job’s Syndrome
Classic of staphylococcal pneumonia in xray
Pneumatocoele
Pneumatocoele is caused by the toxin
Panton Valentin Leukocidin (PVL)
Consistent finding in Hyper IgE
Eosinophilia
Total serum IgE: 2000 IU/ml
Defect in chemotaxis
Results from dysmorphogenesis of 3rd and 4th pharyngeal pouch during early embryogenesis
Variable hypoplasia of the thymus and parathyroid gland
Thymic hypoplasia
DiGeorge Syndrome
Ca levels in thymic hypoplasia
decreased serum calcium
hypocalcemia
Hypocalcemia manifests as
Spasm/tetany
Thymic hypoplasia presents with
Absent cell mediated immunity (CMI) low T cell count
Poor defense against viral and fungal infection
DiGeorge Syndrome is brought about by deletion of chromosome
ch22q11
CATCH 22 syndrome
Cardiac Abnormal facie Thymic hypoplasia Cleft palate Hypocalcemia
Partial/incomplete thymic hypoplasia
Thymic hyoplasia
DiGeorge Syndrome
may present with
Tetany
Congenital defects of heart and great vessels
Problem with both B and T cell
SCID
Defects in both humoral and cell mediated immune response
Thrush
Extensive diaper rash
Failure to thrive
Severe Combined Immunodeficiency