Immunodeficiency Syndrome Flashcards

1
Q

Primary Immunodeficiency

A

genetic defects, rare

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2
Q

Acquired Immunodeficiency

A

secondary due to infection, immunosuppressive drugs or malnutrition

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3
Q

types of acquired immunodeficiency

A

humoral(plasma), cellular, combined

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4
Q

main consequence of immunodeficiency

A

increased susceptibility to infection

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5
Q

Primary Immunodeficiency

intrinsic defects (3)

A
  • Missing enzyme
  • missing cell type
  • Non-functining component

Congenital/Aquired

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6
Q

Secondary Immunodeficiency

Underyling disease (4)

A
  • Lymphoid malignancy
  • Infection (HIV)
  • Malnutrition
  • Immunosuppressive drugs

always acquired

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7
Q

Primary/Congenital Humoral Immunodeficiencies

A
  • Hypogammaglobulinemias (low leve Ab)
  • Agammaglobulinemias (No Ab)
  • Hyper-IgM syndrome (only IgM, no class switch)
  • Selective IgA deficiency (mucosal infection)
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8
Q

Transient Hypogammaglobulinemia of Infancy (Primary)

A
  • Normal, physiological phenomenon
  • delay in B-lymphocyte development results in decreased Ab levels
  • usually doesn’t require therapy

Symtoms

  • increased frequency of bacterial infections
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9
Q

Infant’s maternal IgG

A
  • from collustrum
  • lasts for about 1 month
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10
Q

at 9 months an infant

A

develops own Ab

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11
Q

Bruton’s Agammaglobulinemia

(X-linked, Primary)

trigger

treatment

A

Trigger

  • circulating mature B cell deficiency
  • mutation/deletion of B cell tyrosine kinase (Btk) gene
  • Failure of B cells to mature in bone marrow
  • Absence of Ab in the blood
  • T cells normal, B cell issue

Treatment

  • prevent infections via vaccinations
  • antibiotics
  • monthly injections of intravenous immunoglobulin (IVIg)
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12
Q

Hyper-IgM Syndrome

(X-linked, Primary)

Trigger

symptoms

treatment

A

Trigger

  • B lymphocytes can’t class switch (only IgM)
  • defects/muations in CD40L
  • or defects in activation-induced (AID) enzyme
  • Th cells do not stimulate B cells to undergo heavy chain isotype switching (IgM)
  • lack of IgG

Symptoms

  • easily gets infections ( bacterial, fungal, opportunisitic)

Treatment

  • monthly injection of intravenous immunoglobulin (IVIg)
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13
Q

Selective Immunoglobulin Isotype Deficiency (Primary)

trigger

symtoms

A

Effects on oral health is unclear

Symtoms

  • respirtory infections and diarrhea
  • Celiac disease
  • oral mucosal infections (Herpes…)

Trigger

  • IgA deficiency
    • most common immunodeficiency in caucasians
    • Low serum IgA
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14
Q

Common Variable Immunodeficiency (CVID)

triggers

treatment

A
  • Most common Antibody deficiency
  • Defects in B cell differentiation
    • Mature B cells are present
    • No plasma cells
  • Patients have low levels of IgG and IgA
    • causes infections
    • more malignant tumors
    • shortened lifespan

Treatment: receive IVIg

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15
Q

DiGeorge Syndrome

A
  • Cellular Immunodeficiencies (primary)
  • Defect in T lymphocytes (thymus doesn’t form)
  • Normal B lymphocytes
  • Recurrent viral infections

Treatment

  • transplantation with a fetal thymus
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16
Q

Why are there only increase in viral infections in DiGeorge Syndrome?

A

Because the disease affects T cells

viral infections → intercellular →CD8 T cells

17
Q

Severe Combined Immunodeficiencies Disease (SCID)
X-linked

triggers

treatment

A
  • primary immunodeficiency
  • Cell-mediated and humoral immunity deficienct
  • reduced B and T lymphocytes
  • Extremely infection-prone ( respiratory infection, oral thrush)
    • “Boy in the plastic bubble”

Treatment

  • Bone marrow transplant
18
Q

Chronic Granulomatous Disease (CGD)

triggers

symmtoms

treatment

A
  • Cellular Primary

Triggers

  • Defect in Phagocytes to produce H2O2 and randical .O2- due to genetic defects NADPH oxidase (Can’t kill pathogen)

Symmtoms

  • susceptible to pneumonia
  • infection of lymph nodes and lungs
  • abscesses of the skin and liver

Treatment

  • Antibiotic (long-term, prophylactic): Amphotericin B IV
  • IFN-gamma injections to activate macrophages
19
Q

Acquired Immunodeficiency

A
  • malnutrition, cancer, HIV
20
Q

how to go from HIV to AIDS

A
  • HIV binds to CD4 on TH cells
  • HIV replicates in the TH cells
  • TH presents HIV antigen to CD8+ CTL
  • CTL destroys TH cells
  • Low CD4+ TH count
21
Q

treatment for HIV

A
  • Triple drug therapy (HAART)
    • Highlyactive anti-ertroviral therapy
22
Q

When to get AIDS status?

A

CD4+ T cell count is 1/10th of normal healthy individual

23
Q

HIV and Periodontal Disease

A
  • Low CD4+ cell counts and high viral loads leads to..
    • Destructive periodontal infection and other oral manifestations
    • 9x greater chance
24
Q

what are low levels of CD4+ cells (Number)

A

< 200cells/mm3

25
Q

HIV and types of oral manifestations and periodontal Disase

A
  • oral lesions with aphthous ulceration
  • oral hairy leukoplakia
  • oral candidiasis
  • periodontal attachment loss
  • Gingival recession
  • necrotizing ulcerative periodontitis
  • necrotizing ulcerative stomatitis
  • inflammation ans tissue distruction
26
Q

Oral candidiasis

A
  • White lesions on palate
  • First opportunistic infection in patients with HIV
    • marker of mild immunodeficiency