Affiliation:
1. Department of Pulmonology and Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
2. Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
Abstract
Background and Objective:
Underlying immunodeficiency is a risk factor for recurrent pneumonia. We tried to estimate the prevalence of inborn errors of immunity (IEI) in children with recurrent multilobular pneumonia and analyzed the history, examination findings, and basic investigations to derive clues for early diagnosis in a resource-poor hospital setting.
Materials and Methods:
This prospective observational study was conducted in a tertiary care pediatric teaching hospital in South India over 2 years. Details about each patient including demographics, clinical profile, treatment history, and outcomes were obtained.
Results:
Among 76 children with recurrent multilobar pneumonia, 30 children (39.47%) were proved to have IEI. The significant pointers to the diagnosis of IEI in history were chronic recurrent rhinosinusitis (P < 0.001), otitis media (P = 0.033), tonsillar atrophy (P = 0.022), widespread skin and soft-tissue infections and abscesses (P < 0.001), mucosal candidiasis (P = 0.008), recurrent diarrhea (P = 0.016), lymphopenia for age (P < 0.001), thrombocytopenia (P = 0.005), and abnormal peripheral smear other than hypochoromic microcytic anemia (P < 0.001).
Conclusions:
IEI prevalence is higher than expected with some easily appreciable clues in basic examination and laboratory findings. Clinicians should keep these pointers in mind while dealing with any child with recurrent pneumonia.