Immunodeficiency in Children Information -

By: peterhutch

Immune deficiency may also be the result of particular external processes or diseases; the resultant state is called "secondary" or "acquired" immunodeficiency. Common causes for secondary immunodeficiency are malnutrition, aging and particular medications (e.g. chemotherapy, disease-modifying antirheumatic drugs, immunosuppressive drugs after organ transplants, glucocorticoids).

The immune system is made up of lymphoid tissue in the body, which includes the bone marrow, lymph nodes, thymus, tonsils, and parts of the spleen and gastrointestinal tract. When the immune system detects an antigen, it responds by producing antibodies that destroy the harmful substances. The immune system response also involves a process called phagocytosis. During this process, certain white blood cells swallow and destroy bacteria and other foreign substances.

Human immunodeficiency virus infection (HIV) is caused by the retrovirus HIV-1 (and less commonly by the related retrovirus HIV-2). Infection leads to progressive immunologic deterioration and opportunistic infections and malignancies; the end stage is acquired immunodeficiency syndrome (AIDS).
Diagnosis is by viral antibodies in children > 18 mo and viral PCR assay in those < 18 mo. Treatment is with combinations of antiretroviral agents.

Children with immunodeficiency disorders have frequent infections, such as recurrent respiratory infections. A simple sore throat or cold will lead to severe bacterial infections, most commonly bronchitis, sinusitis, and ear infections (otitis). Chronic bronchitis can develop into pneumonia. It is common for children with immunodeficiencies to develop thrush, a fungal infection of the mouth, and other infections of the skin and mucous membranes in the eyes, mouth, and genital area. Gastrointestinal infections cause diarrhea, weight loss, and failure to thrive. Other symptoms in children with immunodeficiency disorders include hair loss, eczema, areas of broken blood vessels near the surface of the skin, enlarged lymph nodes, distended stomachs, and unnaturally pale skin.

Immunodeficiency disorders are grouped by which part of the immune system (see Biology of the Immune System: Introduction) is affected. They may involve problems with antibodies (due to abnormalities in B lymphocytes, a type of white blood cell), T lymphocytes (a type of white blood cell that helps identify and destroy foreign or abnormal cells), both B and T lymphocytes, phagocytes (cells that ingest and kill microorganisms), or complement proteins. The affected component of the immune system may be missing, reduced in number, or abnormal and malfunctioning.

Many specific diseases directly or indirectly impair the immune system. This includes many types of cancer, particularly those of the bone marrow and blood cells (leukemia, lymphoma, multiple myeloma), and certain chronic infections. Immunodeficiency is also the hallmark of acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV). HIV directly attacks the immune system.

Children with immunodeficiency disorders have frequent infections, such as recurrent respiratory infections. A simple sore throat or cold will lead to severe bacterial infections, most commonly bronchitis, sinusitis, and ear infections (otitis). Chronic bronchitis can develop into pneumonia. It is common for children with immunodeficiencies to develop thrush, a fungal infection of the mouth, and other infections of the skin and mucous membranes in the eyes, mouth, and genital area. Gastrointestinal infections cause diarrhea, weight loss, and failure to thrive. Other symptoms in children with immunodeficiency disorders include hair loss, eczema, areas of broken blood vessels near the surface of the skin, enlarged lymph nodes, distended stomachs, and unnaturally pale skin.

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