Report of the National Immunoglobulin Replacement Expert Committee: algorithm for diagnosis of immunodeficiency requiring antibody replacement therapy

Author:

Betschel Stephen1,Brager Rae2,Haynes Alison3,Issekutz Thomas4,Kim Vy Hong-Diep5,Mazer Bruce6,McCusker Christine6,Roifman Chaim M.57,Rubin Tamar8,Sussman Gordon9,Turvey Stuart10,Waserman Susan11

Affiliation:

1. Division of Clinical Immunology and Allergy, St. Michael’s Hospital, University of Toronto, Toronto, ON

2. Department of Pediatrics, McMaster Children’s Hospital, Hamilton, ON

3. Department of Pediatrics, The Janeway Children’s Hospital, Memorial University of Newfoundland, St. John’s, NL

4. Division of Immunology, IWK Health Centre, Dalhousie University, Halifax, NS

5. Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON

6. Division of Pediatric Allergy and Immunology, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Center, Montreal, QC

7. Canadian Centre for Primary Immunodeficiency, The Hospital for Sick Children, Toronto, ON

8. Pediatric Clinical Immunology and Allergy, University of Manitoba, Winnipeg, MB

9. Clinical Immunology and Allergy, Faculty of Medicine, University of Toronto, Toronto, ON

10. Division of Clinical Immunology and Allergy, Department of Pediatrics, BC Children’s Hospital, University of British Columbia, Vancouver, BC

11. Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON

Abstract

Immunoglobulin replacement therapy is a mainstay in the treatment of immune deficiencies characterized by antibody failure. Whether the cause is primary or secondary, affected patients frequently present with a history recurrent and complicated infections of the upper and (or) lower respiratory tract. Such replacement therapy has been available since the 1980s, although treatment modalities have since been refined to provide improved protection against infections resulting in reduced morbidity and mortality. Here, we describe an algorithm for diagnosing patients with suspected primary or secondary immunodeficiency, including assessment of clinical, laboratory, and genetic information, when considering initiating immunoglobulin replacement. The increasing availability of molecular genetic techniques will likely result in decreased diagnostic delay for these patients. Statement of novelty: We describe here an algorithm for diagnosing patients with immunodeficiency requiring immunoglobulin replacement therapy.

Publisher

LymphoSign Journal Limited Partnership

Subject

General Earth and Planetary Sciences,General Environmental Science

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