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The Clinical and Immunological Features of Patients with Primary Antibody Deficiencies

[ Vol. 18 , Issue. 5 ]

Author(s):

Gholamreza Azizi, Yasser Bagheri, Marzieh Tavakol, Forough Askarimoghaddam, Kumars Porrostami, Hosein Rafiemanesh, Reza Yazdani, Fatemeh Kiaee, Sima Habibi, Kosar Abouhamzeh, Hamed Mohammadi, Mostafa Qorbani, Hassan Abolhassani and Asghar Aghamohammadi*   Pages 537 - 545 ( 9 )

Abstract:


Background: Primary antibody deficiency (PAD) comprises a range of diseases from early to late terminal B cells defects and is associated with the various clinical complications.

Methods: A total of 461 patients (311 males and 150 females) with PADs enrolled in the retrospective cohort study and for all patients’ demographic information, clinical records and laboratory data were collected to investigate clinical complications.

Results: The most prevalent first presentations of immunodeficiency were respiratory tract infections in 63.5% and chronic diarrhea in 17.2%. Common variable immune deficiency (CVID) patients had a higher diagnostic delay than class switching defect (CSD), and agammaglobulinemia. Among the noninfectious complications, autoimmunity (26.2%), and splenomegaly (23.4%) were the most common. Lymphadenopathy was higher in CSD patients than other PADs, while splenomegaly, hepatomegaly, autoimmunity and bronchiectasis were more common in CVID patients than others. Atopic manifestations were mostly recorded in patients with selective IgA deficiency. Malignancy was only reported in 5.8% of patients with CVID. There was a higher prevalence of autoimmune manifestations in CVID comparing to other PADs.

Conclusion: PADs are relatively rare diseases and these patients have a variety of first clinical manifestations, such as diverse infections, autoimmunity, lymphoproliferation, allergy, enteropathy and malignancy. Practitioner’s awareness about the heterogeneous presentations of PAD disorders is poor, therefore patients often are lately diagnosed, and they are complicated with several clinical complications before the certain diagnosis.

Keywords:

Primary antibody deficiencies, infection, non-infectious complication, morbidity and mortality, CVID, respiratory tract infection.

Affiliation:

Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Clinical Research Development Unit (CRDU), 5 azar Hospital, Golestan University of Medical Sciences, Gorgan, Department of Allergy and Clinical Immunology, Shahid Bahonar Hospital, Alborz University of Medical Sciences, Karaj, Department of Allergy and Clinical Immunology, Shahid Bahonar Hospital, Alborz University of Medical Sciences, Karaj, Department of Pediatrics, Shahid Bahonar Hospital, Alborz University of Medical Sciences, Karaj, Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Dietary supplements and Probiotic Research Center, Alborz University of Medical Science, Karaj, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran, Research Center for Immunodeficiencies, Children`s Medical Center, Tehran University of Medical Sciences, Tehran

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