Recognizing immunodeficiency in children with recurrent infections: What are the predictive factors?

Recognizing immunodeficiency in children with recurrent infections: What are the predictive factors?

Sütçü M, Acar M, Aktürk H, Hançerli-Törün S, Salman N, Somer A. Recognizing immunodeficiency in children with recurrent infections: What are the predictive factors? The aim of this study was to evaluate the children presenting with the complaint of recurrent infections and to determine the possible predictive factors foreseeing the requirement for further investigations. Turk J Pediatr 2016; 58: 609-615.This study is a retrospective analysis of 507 children (221 female, 43.6%) with median age of 46 months, who attended our department with the complaint of recurrent infections between January 2013 and December 2014 during two years period. The majority of the patients were preschool age children (n: 360, 71%). Most of the infections were upper repiratory tract infections [URTI (n: 380, 75%)]. The patients were divided into 4 diagnostic groups; as atopic children (n: 148, 29.2%), children with primary immune deficiency [PID (n: 54, 10.7%)], patients with chronic disorders (n: 40, 7.9%) and the majority, healthy subjects (n: 265, 52.3%). Among school age patients, the incidence of atopic children was significantly high (p: 0.016). Presenting at adolescent age group, growth retardation and hypogammaglobulinemia were the predictive risk factors for PID. Antibody (B cell) deficiencies (n: 43, 80%), and among those, selective IgA deficiency (n: 23, 4.5%) constituted the majority of the patients in PID. Rheumatological diseases (n: 9, 1.8%), mainly periodic fever syndromes, were the most common chronic disorders. Malignancy (acute lymphoblastic leukemia and lymphoma) was obtained in two patients (0.4%). Complaint of recurrent infections is very common among children attending health care facilities. It is crucial for clinicians to differentiate the children who need further investigations, urgent medical attention

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  • Stiehm ER. Approach to the child with recurrent infections. UpToDate, 2014.
  • 10 Warning Signs: Jeffrey Modell Foundation. Available at: www.jmfworld.com/library/educational- materials/10-warning-signs. Accessed December, 2016.
  • Aksu G, Genel F, Koturoglu G, et al. Serum immunoglobulin (IgG, IgM, IgA) and IgG subclass concentrations in healthy children: a study using nephelometric technique. Turk J Pediatr 2005; 47: 19-24.
  • C l i n i c a l D i a g n o s t i c C r i t e r i a f o r P r i m a r y Immunodeficiencies. Available at: https://esid.org/ Working-Parties/Clinical/Resources/Diagnostic-criteria- for-PID2. Accessed December, 2016.
  • MacGinnitie A, Aloi F, Mishra S. Clinical characteristics of pediatric patients evaluated for primary immunodeficiency. Pediatr Allergy Immunol 2011; 22: 671-675.
  • Monto AS. Viral respiratory infections in the community: epidemiology, agents, and interventions. Am J Med 1995; 99: 24-27.
  • Campbell H. Acute respiratory infection: a global challenge. Arch Dis Child 1995; 73: 281-283.
  • Janson C. The effect of passive smoking on respiratory health in children and adults. Int J Tuberc Lung Dis 2004: 8: 510-516.
  • Grüber C, Keil T, Kulig M, et al. History of respiratory infections in the first 12 yr among children from a birth cohort. Pediatr Allergy Immunol 2008; 19: 505- 512.
  • H o g a n M B , Wi l s o n N W. C o m m o n v a r i a b l e immunodeficiency in children. Up To Date; 2014.
  • Marseglia GL, Avanzini MA, Caimmi S, et al. Passive exposure to smoke results in defective interferon- gamma production by adenoids in children with recurrent respiratory infections. J Interferon Cytokine Res 2009; 29: 427-432.
  • Lugade AA, Bogner PN, Thatcher THJ, et al. Cigarette smoke exposure exacerbates lung inflammation and compromises immunity to bacterial infection. Immunol. 2014; 192: 5226-5235.
  • Janson C. The effect of passive smoking on respiratory health in children and adults. Int J Tuberc Lung Dis 2004: 8: 510-516.
  • Gaffin JM. Postnatal environmental tobacco smoke exposure is associated with objective markers of atopy in preschool-aged children. Evid Based Med 2015; 20: 219-221.
  • Tagliacarne SC, Valsecchi C, Castellazi AM, et al. Impact of passive smoke and/or atopy on adenoid immunoglobulin production in children. Immunol Lett 2015; 165: 70-77.
  • Stiehm ER. The four most common pediatric immunodeficiencies. J Immunotoxicol 2008; 5: 227-234.
  • Bonilla FA, Khan DA, Ballas ZK, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol 2015; 136: 1186-1205.
  • Kasapçopur Ö, Arısoy N. Ailesel Akdeniz Ateşi ve diğer otoenflamatuar hastalıklar. Türk Pediatri Arşivi 2006; 41: 9-17.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: 6
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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