Patient & Family Handbook

Total Page:16

File Type:pdf, Size:1020Kb

Patient & Family Handbook Immune Deficiency Foundation Patient & Family Handbook For Primary Immunodeficiency Diseases This book contains general medical information which cannot be applied safely to any individual case. Medical knowledge and practice can change rapidly. Therefore, this book should not be used as a substitute for professional medical advice. SIXTH EDITION COPYRIGHT 1987, 1993, 2001, 2007, 2013, 2019 IMMUNE DEFICIENCY FOUNDATION Copyright 2019 by Immune Deficiency Foundation, USA. Readers may redistribute this article to other individuals for non-commercial use, provided that the text, html codes, and this notice remain intact and unaltered in any way. The Immune Deficiency Foundation Patient & Family Handbook may not be resold, reprinted or redistributed for compensation of any kind without prior written permission from the Immune Deficiency Foundation. If you have any questions about permission, please contact: Immune Deficiency Foundation, 110 West Road, Suite 300, Towson, MD 21204, USA; or by telephone at 800-296-4433. Immune Deficiency Foundation Patient & Family Handbook For Primary Immunodeficiency Diseases 6th Edition The development of this publication was supported by Shire, now Takeda. 110 West Road, Suite 300 Towson, MD 21204 800.296.4433 www.primaryimmune.org [email protected] Editors Mark Ballow, MD Jennifer Heimall, MD Elena Perez, MD, PhD M. Elizabeth Younger, Executive Editor Children’s Hospital of Philadelphia Allergy Associates of the CRNP, PhD University of South Florida Palm Beaches Johns Hopkins University Jennifer Leiding, MD School of Medicine Kristin Epland, FNP-C University of South Florida Marc Riedl, MD, MS Midwest Immunology Clinic University of California, San Diego Contributors Linda Anastasia, BSN, RN, Kristin Epland, FNP-C Roger Kobayashi, MD Marc Riedl, MD, MS CPN, IgCN Midwest Immunology Clinic Allergy, Asthma and University of California, San Diego The Children’s Hospital of Immunology Associates Philadelphia Elise Ferre, PA-C, MSHS, Sergio Rosenzweig, MD, PhD MPH Lisa Kobrynski, MD National Institutes of Health John Atkinson, MD National Institutes of Health Emory University Hospital Washington University in St. Louis Jack Routes, MD Thomas Fleisher, MD, Donald Kohn, MD Children’s Hospital of Wisconsin Mark Ballow, MD FAAAAI University of California, Los Angeles Cristiane Santos, MD University of South Florida National Institutes of Health Hrish Kulkarni, MD, MSCI National Institutes of Health Leonard Bielory, MD Lisa Forbes Satter, MD Washington University in St. Louis Universidade de São Paulo Robert Wood Johnson University Texas Children’s Hospital Hospital Caroline Kuo, MD William Shearer, MD, PhD Alexandra Freeman, MD University of California, Los Angeles Texas Children’s Hospital Jack Bleesing, MD, PhD National Institutes of Health Cincinnati Children’s Hospital Monica Lawrence, MD Morgan Similuk, MD Medical Center Ramsay Fuleihan, MD University of Virginia National Institute of Health Ann & Robert H. Lurie Children’s Howard Lederman, MD, PhD Maria Slack, MD William Blouin, MSN, ARNP, Hospital Johns Hopkins University University of Rochester Medical CPNP School of Medicine Center, Allergy, Immunology and Allergy and Immunology Care Asal Gharib, MD University of California, Irvine Rheumatology Center of South Florida Jennifer Leiding, MD University of South Florida Ricardo Sorensen, MD Rebecca Buckley, MD Sudhir Gupta, MD, PhD University of California, Irvine Children’s Hospital New Orleans Duke University School of Medicine Michail Lionakis, MD, ScD National Institutes of Health Mark Stein, MD, FACP, Sharat Chandra, MD, David Hagin, MD, PhD FACAAI, FAAAAI MRCPCH University of Tel Aviv Patricia Lugar, MD, MS Allergy Associates of the Palm Cincinnati Children’s Hospital Joud Hajjar, MD, MS Duke University School of Medicine Beaches Medical Center Texas Children’s Hospital Peter Mannon, MD, MPH Kathleen Sullivan, MD, PhD Shanmuganathan Gretchen Harmon, MD The University of Alabama at Children’s Hospital of Philadelphia Chandrakasan, MD Nemours/Alfred I. duPont Hospital Birmingham Children’s Healthcare of Atlanta - for Children Maha Syed, MD Emory Children’s Center M. Louise Markert, PhD, MD Texas Children’s Hospital Jennifer Heimall, MD Duke University School of Medicine Javier Chinen, MD, PhD Children’s Hospital of Philadelphia Troy Torgerson, MD, PhD Texas Children’s Hospital Rebecca Marsh, MD Seattle Children’s Hospital Colleen Hill Dansereau, MSN, Cincinnati Children’s Hospital and Research Institute Medical Center Ivan Chinn, MD RN, CPN, CPHON Texas Children’s Hospital Dana-Farber Boston Children’s Gulbu Uzel, MD Matthew Norris, MD National Institutes of Health Nichole Clark Cancer and Blood Disorders Center Overlook Medical Center Immune Deficiency Foundation Mary Hintermeyer, APNP V. Koneti Rao, MD, FRCPA Luigi Notarangelo, MD National Institutes of Health Charlotte Cunningham- Children’s Hospital of Wisconsin National Institutes of Health Rundles, MD, PhD James Verbsky, MD PhD Steven Holland, MD Hans Ochs, MD Mt. Sinai Medical Center Medical College of Wisconsin National Institutes of Health Seattle Children’s Hospital and Research Institute Blachy Dávila Saldaña, MD Yvonne Hsieh, MD Kelli Williams, MD, MPH Children’s National Medical Center Medical University of South University of California, Irvine Sung-Yun Pai, MD and Research Institute Carolina Dana-Farber Boston Children’s Soma Jyonouchi, MD Cancer and Blood Disorders Center Magee DeFelice, MD, FAAP Children’s Hospital of Philadelphia Elizabeth Wisner, MD Nemours/Alfred I. duPont Hospital Children’s Hospital New Orleans Suhag Parikh, MD for Children Harumi Jyonouchi, MD Duke University Medical Center Saint Peter’s University Hospital M. Elizabeth Younger, CRNP, Ottavia Delmonte, MD PhD Niraj Patel, MD National Institutes of Health Mike Keller, MD Johns Hopkins University School of Levine Children’s Hospital Children’s National Medical Center Medicine Carla Duff, CPNP, MSN, and Research Institute Brian Rath, JD CCRP, IgCN Immune Deficiency Foundation University of South Florida Associate Editors Katherine A. Antilla, MAEd Rachel Delaney Adam Freestone Immune Deficiency Foundation Immune Deficiency Foundation Immune Deficiency Foundation John G. Boyle Brian Fitzek Kara Moran Immune Deficiency Foundation Immune Deficiency Foundation Immune Deficiency Foundation Preface The Immune Deficiency Foundation (IDF) is dedicated to improving the diagnosis, treatment, and quality of life of people affected by primary immunodeficiencies (PI) through fostering a community empowered by advocacy, education, and research. Since it was founded in 1980, one of the ways IDF has advanced these aims is through its publications, such as this IDF Patient & Family Handbook, to provide reliable information about the often unfamiliar diseases to individuals with PI, their families and their healthcare providers. The first edition of the Handbook was published in 1987, and since then tens of thousands of copies have been distributed and it has been translated in part or in whole into at least 13 different languages. The first edition was composed of nine chapters covering five types of PI. By the time the 5th edition was produced, the content of the Handbook by 33 chapters and featured 100 different PIs. This new 6th edition has 46 chapters and includes expanded information on more than 350 types of PI. The Handbook includes an overview of The Immune System and Primary Immunodeficiency Diseases to provide a basic description of the components of the immune system and how its defects lead to disease. There are 24 chapters covering the specific details of many of the individual PIs themselves. There are additional chapters with general information relevant to the inheritance, laboratory diagnosis, general care and specific medical treatments of PI, as well as chapters on life management issues for individuals of different ages. Since the previous edition was released, there have been many important breakthroughs and discoveries regarding PI. All of the existing chapters have been revised and updated with new information and many have been completely rewritten. The authors and editors have tried to condense the often highly technical information available into a form that is informative yet still understandable to a reader not trained in medicine or immunology. We hope that you find the Handbook to be a useful source of information about primary immunodeficiency diseases and would appreciate your feedback so that we can continue to make improvements in future editions. In addition, all the information that is found in the IDF Patient & Family Handbook can be found on the IDF website (www.primaryimmune.org). It is important to recognize that a regular dialogue between the individual with PI, their family, and their healthcare provider team is essential to facilitate the highest quality care. This Handbook is not intended to be a substitute for those critical interactions, but it should be used as a tool for patients and their families. Our goal is to help them understand the information that they receive from their providers and arm them with background information so that they can better communicate with their healthcare team. Each situation is unique and the management of illness and its treatment must be customized to meet their individual needs. The development of a partnership between the individual and family and the healthcare provider is critically important for success in the management of life- long challenges like those presented by PI. The Editors
Recommended publications
  • IDF Patient & Family Handbook
    Immune Deficiency Foundation Patient & Family Handbook for Primary Immunodeficiency Diseases This book contains general medical information which cannot be applied safely to any individual case. Medical knowledge and practice can change rapidly. Therefore, this book should not be used as a substitute for professional medical advice. FIFTH EDITION COPYRIGHT 1987, 1993, 2001, 2007, 2013 IMMUNE DEFICIENCY FOUNDATION Copyright 2013 by Immune Deficiency Foundation, USA. REPRINT 2015 Readers may redistribute this article to other individuals for non-commercial use, provided that the text, html codes, and this notice remain intact and unaltered in any way. The Immune Deficiency Foundation Patient & Family Handbook may not be resold, reprinted or redistributed for compensation of any kind without prior written permission from the Immune Deficiency Foundation. If you have any questions about permission, please contact: Immune Deficiency Foundation, 110 West Road, Suite 300, Towson, MD 21204, USA; or by telephone at 800-296-4433. Immune Deficiency Foundation Patient & Family Handbook for Primary Immunodeficency Diseases 5th Edition This publication has been made possible through a generous grant from Baxalta Incorporated Immune Deficiency Foundation 110 West Road, Suite 300 Towson, MD 21204 800-296-4433 www.primaryimmune.org [email protected] EDITORS R. Michael Blaese, MD, Executive Editor Francisco A. Bonilla, MD, PhD Immune Deficiency Foundation Boston Children’s Hospital Towson, MD Boston, MA E. Richard Stiehm, MD M. Elizabeth Younger, CPNP, PhD University of California Los Angeles Johns Hopkins Los Angeles, CA Baltimore, MD CONTRIBUTORS Mark Ballow, MD Joseph Bellanti, MD R. Michael Blaese, MD William Blouin, MSN, ARNP, CPNP State University of New York Georgetown University Hospital Immune Deficiency Foundation Miami Children’s Hospital Buffalo, NY Washington, DC Towson, MD Miami, FL Francisco A.
    [Show full text]
  • Obstructive Sleep Apnea
    ObSTruCTIve Sleep ApneA provider’s guide to diagnose and code sleep apnea Sleep apnea is a common disorder that by When reviewing these symptoms it is helpful definition is characterized by a reduction in to clarify the history with the patient’s sleeping normal breathing during hours of sleep, often partner, when available. The most useful symptom related to the collapse of the soft tissues in the for identifying patients with OSA is nocturnal back of the throat. Obstructive sleep apnea (OSA) choking or gasping. Snoring alone is not a is the most common sleeping disorder. It has been diagnostic predictor for OSA. However, the lack diagnosed in 3 to 7% of Americans. It is estimated of snoring and/or presence of apnea reduce the that 20% of the entire American population has not likelihood of an OSA diagnosis. been diagnosed. Quantification of the patient’s perception Independent risk factors for of daytime sleepiness and/or fatigue is an important historical finding. This can be developing OSA include: determined by using the Epworth Sleepiness › Obesity (BMI > 30 kg/m2) Scale (epworthsleepinessscale.com). A score of 10 supports the hypothesis of excessive daytime › African – American race sleepiness, which should prompt the clinician to › Male gender have the patient tested for OSA. › Advancing age › Cranio – facial anomalies The physical examination should focus on: Smoking › 1. Review of the oral airway, specifically: › Controlled substance use and alcohol intake the size of the uvula and tonsils, and › Chronic medical conditions such as: the presence of nasal septal deviation end-stage renal disease, congestive heart failure, 2.
    [Show full text]
  • WHIM Syndrome: from Pathogenesis Towards Personalized Medicine and Cure
    Journal of Clinical Immunology (2019) 39:532–556 https://doi.org/10.1007/s10875-019-00665-w CME REVIEW WHIM Syndrome: from Pathogenesis Towards Personalized Medicine and Cure Lauren E. Heusinkveld1,2 & Shamik Majumdar1 & Ji-Liang Gao1 & David H. McDermott1 & Philip M. Murphy1 Received: 22 April 2019 /Accepted: 26 June 2019 /Published online: 16 July 2019 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019 Abstract WHIM syndrome is a rare combined primary immunodeficiency disease named by acronym for the diagnostic tetrad of warts, hypogammaglobulinemia, infections, and myelokathexis. Myelokathexis is a unique form of non-cyclic severe congenital neutropenia caused by accumulation of mature and degenerating neutrophils in the bone marrow; monocytopenia and lympho- penia, especially B lymphopenia, also commonly occur. WHIM syndrome is usually caused by autosomal dominant mutations in the G protein-coupled chemokine receptor CXCR4 that impair desensitization, resulting in enhanced and prolonged G protein- and β-arrestin-dependent responses. Accordingly, CXCR4 antagonists have shown promise as mechanism-based treatments in phase 1 clinical trials. This review is based on analysis of all 105 published cases of WHIM syndrome and covers current concepts, recent advances, unresolved enigmas and controversies, and promising future research directions. Keywords Chemokine . CXCL12 . CXCR4 . CXCR2 . myelokathexis . human papillomavirus . plerixafor Historical Background [M:E] ratio with a “shift to the right”); and (3) numerous dysmorphic bone marrow neutrophils having cytoplasmic Myelokathexis was first described as a new type of severe hypervacuolation and hyperlobulated pyknotic nuclear lobes congenital neutropenia in 1964 by Krill and colleagues from connected by long thin strands (Fig.
    [Show full text]
  • Hemoptysis in Children
    R E V I E W A R T I C L E Hemoptysis in Children G S GAUDE From Department of Pulmonary Medicine, JN Medical College, Belgaum, Karnataka, India. Correspondence to: Dr G S Gaude, Professor and Head, Department of Pulmonary Medicine, J N Medical College, Belgaum 590 010, Karnataka, India. [email protected] Received: November, 11, 2008; Initial review: May, 8, 2009; Accepted: July 27, 2009. Context: Pulmonary hemorrhage and hemoptysis are uncommon in childhood, and the frequency with which they are encountered by the pediatrician depends largely on the special interests of the center to which the child is referred. Diagnosis and management of hemoptysis in this age group requires knowledge and skill in the causes and management of this infrequently occurring potentially life-threatening condition. Evidence acquisition: We reviewed the causes and treatment options for hemoptysis in the pediatric patient using Medline and Pubmed. Results: A focused physical examination can lead to the diagnosis of hemoptysis in most of the cases. In children, lower respiratory tract infection and foreign body aspiration are common causes. Chest radiographs often aid in diagnosis and assist in using two complementary diagnostic procedures, fiberoptic bronchoscopy and high-resolution computed tomography. The goals of management are threefold: bleeding cessation, aspiration prevention, and treatment of the underlying cause. Mild hemoptysis often is caused by an infection that can be managed on an outpatient basis with close monitoring. Massive hemoptysis may require additional therapeutic options such as therapeutic bronchoscopy, angiography with embolization, and surgical intervention such as resection or revascularization. Conclusions: Hemoptysis in the pediatric patient requires prompt and thorough evaluation and treatment.
    [Show full text]
  • Two Locus Inheritance of Non-Syndromic Midline Craniosynostosis Via Rare SMAD6 and 4 Common BMP2 Alleles 5 6 Andrew T
    1 2 3 Two locus inheritance of non-syndromic midline craniosynostosis via rare SMAD6 and 4 common BMP2 alleles 5 6 Andrew T. Timberlake1-3, Jungmin Choi1,2, Samir Zaidi1,2, Qiongshi Lu4, Carol Nelson- 7 Williams1,2, Eric D. Brooks3, Kaya Bilguvar1,5, Irina Tikhonova5, Shrikant Mane1,5, Jenny F. 8 Yang3, Rajendra Sawh-Martinez3, Sarah Persing3, Elizabeth G. Zellner3, Erin Loring1,2,5, Carolyn 9 Chuang3, Amy Galm6, Peter W. Hashim3, Derek M. Steinbacher3, Michael L. DiLuna7, Charles 10 C. Duncan7, Kevin A. Pelphrey8, Hongyu Zhao4, John A. Persing3, Richard P. Lifton1,2,5,9 11 12 1Department of Genetics, Yale University School of Medicine, New Haven, CT, USA 13 2Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA 14 3Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA 15 4Department of Biostatistics, Yale University School of Medicine, New Haven, CT, USA 16 5Yale Center for Genome Analysis, New Haven, CT, USA 17 6Craniosynostosis and Positional Plagiocephaly Support, New York, NY, USA 18 7Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA 19 8Child Study Center, Yale University School of Medicine, New Haven, CT, USA 20 9The Rockefeller University, New York, NY, USA 21 22 ABSTRACT 23 Premature fusion of the cranial sutures (craniosynostosis), affecting 1 in 2,000 24 newborns, is treated surgically in infancy to prevent adverse neurologic outcomes. To 25 identify mutations contributing to common non-syndromic midline (sagittal and metopic) 26 craniosynostosis, we performed exome sequencing of 132 parent-offspring trios and 59 27 additional probands.
    [Show full text]
  • Khan CV 9-4-20
    CURRICULUM VITAE DAVID A. KHAN, MD University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard Dallas, TX 75390-8859 (214) 648-5659 (work) (214) 648-9102 (fax) [email protected] EDUCATION 1980 -1984 University of Illinois, Champaign IL; B.S. in Chemistry, Magna Cum Laude 1984 -1988 University of Illinois School of Medicine, Chicago IL; M.D. 1988 -1991 Good Samaritan Medical Center, Phoenix AZ; Internal Medicine internship & residency 1991-1994 Mayo Clinic, Rochester MN; Allergy & Immunology fellowship PROFESSIONAL EXPERIENCE 1994 -2001 Assistant Professor of Internal Medicine, UT Southwestern 1997 -1998 Co-Director, Allergy & Immunology Training Program 1998 - Director, Allergy & Immunology Training Program 2002- 2008 Associate Professor of Internal Medicine, UT Southwestern 2008-present Professor of Medicine, UT Southwestern AWARDS/HONORS 1993 Allen & Hanburys Respiratory Institute Allergy Fellowship Award 1993 Von Pirquet Award 2001 Outstanding Teacher 2000-2001 UTSW Class of 2003 2004 Outstanding Teacher 2003-2004 UTSW Class of 2006 2005 Outstanding Teacher 2004-2005 UTSW Class of 2007 2006 Daniel Goodman Lectureship, ACAAI meeting 2007 Most Entertaining Teacher 2006-2007 UTSW Class of 2009 2008 Stanislaus Jaros Lectureship, ACAAI meeting 2009 Outstanding Teacher 2007-2008 UTSW Class of 2010 2011 John L. McGovern Lectureship, ACAAI meeting 2012 I. Leonard Bernstein Lecture, ACAAI meeting 2014 Distinguished Fellow, ACAAI meeting 2015 Elliot F. Ellis Memorial Lectureship, AAAAI meeting 2015 Bernard Berman Lectureship,
    [Show full text]
  • IDF Guide to Hematopoietic Stem Cell Transplantation
    Guide to Hematopoietic Stem Cell Transplantation Immune Deficiency Foundation Guide to Hematopoietic Stem Cell Transplantation This publication contains general medical information that cannot be applied safely to any individual case. Medical knowledge and practice can change rapidly. Therefore, this publication should not be used as a substitute for professional medical advice. In all cases, patients and caregivers should consult their healthcare providers. Each patient’s condition and treatment are unique. Copyright 2018 by Immune Deficiency Foundation, USA Readers may redistribute this guide to other individuals for non-commercial use, provided that the text, html codes, and this notice remain intact and unaltered in any way. Immune Deficiency Foundation Guide to Hematopoietic Stem Cell Transplantation may not be resold, reprinted or redistributed for compensation of any kind without prior written permission from the Immune Deficiency Foundation (IDF). If you have any questions about permission, please contact: Immune Deficiency Foundation, 110 West Road, Suite 300, Towson, MD 21204, USA, or by telephone: 800-296-4433. For more information about IDF, go to: www.primaryimmune.org. This publication has been made possible through the IDF SCID Initiative and the SCID, Angels for Life Foundation. Acknowledgements The Immune Deficiency Foundation would like to thank the organizations and individuals who helped make this publication possible and contributed to the development of the Immune Deficiency Foundation Guide to Hematopoietic Stem
    [Show full text]
  • Repercussions of Inborn Errors of Immunity on Growth☆ Jornal De Pediatria, Vol
    Jornal de Pediatria ISSN: 0021-7557 ISSN: 1678-4782 Sociedade Brasileira de Pediatria Goudouris, Ekaterini Simões; Segundo, Gesmar Rodrigues Silva; Poli, Cecilia Repercussions of inborn errors of immunity on growth☆ Jornal de Pediatria, vol. 95, no. 1, Suppl., 2019, pp. S49-S58 Sociedade Brasileira de Pediatria DOI: https://doi.org/10.1016/j.jped.2018.11.006 Available in: https://www.redalyc.org/articulo.oa?id=399759353007 How to cite Complete issue Scientific Information System Redalyc More information about this article Network of Scientific Journals from Latin America and the Caribbean, Spain and Journal's webpage in redalyc.org Portugal Project academic non-profit, developed under the open access initiative J Pediatr (Rio J). 2019;95(S1):S49---S58 www.jped.com.br REVIEW ARTICLE ଝ Repercussions of inborn errors of immunity on growth a,b,∗ c,d e Ekaterini Simões Goudouris , Gesmar Rodrigues Silva Segundo , Cecilia Poli a Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Pediatria, Rio de Janeiro, RJ, Brazil b Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Curso de Especializac¸ão em Alergia e Imunologia Clínica, Rio de Janeiro, RJ, Brazil c Universidade Federal de Uberlândia (UFU), Faculdade de Medicina, Departamento de Pediatria, Uberlândia, MG, Brazil d Universidade Federal de Uberlândia (UFU), Hospital das Clínicas, Programa de Residência Médica em Alergia e Imunologia Pediátrica, Uberlândia, MG, Brazil e Universidad del Desarrollo,
    [Show full text]
  • Newborn Screening for Severe Combined Immunodeficiency And
    Newborn screening for SCID and related forms of Primary Immunodeficiency Michael Keller, MD Division of Allergy and Immunology Aims To review the epidemiology and possible presentations of primary immunodeficiency disorders. To learn about the TREC newborn screening assay, and what to do with a positive result. Speaker Disclosures No disclosures to declare. Case: 10 month old girl Ex FT infant, poor weight and chronic diarrhea since 2 months of age. No prior known infections, negative FH. Initial workup CBC: CMP: Na: 135 WBC: 5.6 K: 3.9 Hb: 11.3 Cl: 104 Hct: 34.1 CO2: 24 MCV: 79.1 BUN: 4 Plt: 386 Cr: 0.2 ANC: 2055 Glu: 70 Total protein: 4.9 ALC: 3102 Albumin: 3.0 Eos: 0.2% Alk Phos: 126 Monos: 6.9% ALT: 84 AST: 87 Phos: 4.8 Mg: 2.3 GGT: 17 Differential . Primary GI disease . IBD, allergic enterocolitis, . GI channelopathy . Metabolic disorder or CF . Newborn screening catches many but not all . Chronic infection . HIV . Immune disorder Further testing • Stool testing: negative for norovirus, enterovirus, parechovirus, adenovirus, O&P, culture • Negative CMV, EBV PCRs (blood) • Normal fecal elastase (434) • Positive Rotavirus Antigen EIA Further testing Hypogammaglobulinemia No vaccine responses Further testing Lymphocyte Flow Cytometry Marker Value Normal range (cells/mcl) (cells/mcl) CD3+ (T-cells) 242 1600-6700 CD3/CD4+ 86 1000-4600 CD3/CD8+ 15 400-2100 CD4/CD45RA+ 61 500-1100 CD4/CD45RO+ 57 150-600 CD16/56+, CD3- (NK cells) 223 200-1200 CD19+ (B-cells) 1735 600-2700 Profound T-cell Lymphocytopenia Diagnosis Dx: Severe combined immunodeficiency Epidemiology: Primary immunodeficiency Over 200+ known congenital immunologic defects • In total, primary immunodeficiency is thought to occur as frequent as 1 in 5000.
    [Show full text]
  • Type of the Paper (Article
    Supplementary Material A Proteomics Study on the Mechanism of Nutmeg-induced Hepatotoxicity Wei Xia 1, †, Zhipeng Cao 1, †, Xiaoyu Zhang 1 and Lina Gao 1,* 1 School of Forensic Medicine, China Medical University, Shenyang 110122, P. R. China; lessen- [email protected] (W.X.); [email protected] (Z.C.); [email protected] (X.Z.) † The authors contributed equally to this work. * Correspondence: [email protected] Figure S1. Table S1. Peptide fraction separation liquid chromatography elution gradient table. Time (min) Flow rate (mL/min) Mobile phase A (%) Mobile phase B (%) 0 1 97 3 10 1 95 5 30 1 80 20 48 1 60 40 50 1 50 50 53 1 30 70 54 1 0 100 1 Table 2. Liquid chromatography elution gradient table. Time (min) Flow rate (nL/min) Mobile phase A (%) Mobile phase B (%) 0 600 94 6 2 600 83 17 82 600 60 40 84 600 50 50 85 600 45 55 90 600 0 100 Table S3. The analysis parameter of Proteome Discoverer 2.2. Item Value Type of Quantification Reporter Quantification (TMT) Enzyme Trypsin Max.Missed Cleavage Sites 2 Precursor Mass Tolerance 10 ppm Fragment Mass Tolerance 0.02 Da Dynamic Modification Oxidation/+15.995 Da (M) and TMT /+229.163 Da (K,Y) N-Terminal Modification Acetyl/+42.011 Da (N-Terminal) and TMT /+229.163 Da (N-Terminal) Static Modification Carbamidomethyl/+57.021 Da (C) 2 Table S4. The DEPs between the low-dose group and the control group. Protein Gene Fold Change P value Trend mRNA H2-K1 0.380 0.010 down Glutamine synthetase 0.426 0.022 down Annexin Anxa6 0.447 0.032 down mRNA H2-D1 0.467 0.002 down Ribokinase Rbks 0.487 0.000
    [Show full text]
  • Advances in Dental Research
    Advances in Dental Research http://adr.sagepub.com/ The Association Between Immunodeficiency and the Development of Autoimmune Disease J.W. Sleasman ADR 1996 10: 57 DOI: 10.1177/08959374960100011101 The online version of this article can be found at: http://adr.sagepub.com/content/10/1/57 Published by: http://www.sagepublications.com On behalf of: International and American Associations for Dental Research Additional services and information for Advances in Dental Research can be found at: Email Alerts: http://adr.sagepub.com/cgi/alerts Subscriptions: http://adr.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Downloaded from adr.sagepub.com by guest on July 18, 2011 For personal use only. No other uses without permission. THE ASSOCIATION BETWEEN IMMUNODEFICIENCY AND THE DEVELOPMENT OF AUTOIMMUNE DISEASE J.W. SLEASMAN aradoxically, individuals with primary or acquired immunodeficiency disease have an increased Division of Pediatric Immunology and Allergy incidence of autoimmunity. Human primary University of Florida College of Medicine immunodeficiency disease can be classified as Box 100296, 1600 SW Archer Road P disorders of cell-mediated immunity, humoral immunity, Gainesville, Florida 32610-0296 phagocytic cell function, and the complement system (Barrett and Sleasman, 1990). Cell-mediated and humoral immunity Adv Dent Res 10(l):57-61, April, 1996 comprise the adaptive arm of the immune response, which is antigen-specific and confers immunologic memory. The innate immune response, which is antigen-nonspecific, is Abstract—There is a paradoxical relationship between composed of phagocytic cells and the inflammatory peptides. immunodeficiency diseases and autoimmunity. While not all Not all individuals with inherited immunodeficiency develop individuals with immunodeficiency develop autoimmunity, autoimmunity, nor are all individuals with autoimmune nor are all individuals with autoimmunity immunodeficient, disease immunodeficient.
    [Show full text]
  • Comprehensive Genetic Testing for Primary Immunodeficiency
     Woon and Ameratunga Allergy Asthma Clin Immunol (2016) 12:65 Allergy, Asthma & Clinical Immunology DOI 10.1186/s13223-016-0169-2 RESEARCH Open Access Comprehensive genetic testing for primary immunodeficiency disorders in a tertiary hospital: 10‑year experience in Auckland, New Zealand See‑Tarn Woon and Rohan Ameratunga* Abstract Background and purpose: New Zealand is a developed geographically isolated country in the South Pacific with a population of 4.4 million. Genetic diagnosis is the standard of care for most patients with primary immunodeficiency disorders (PIDs). Methods: Since 2005, we have offered a comprehensive genetic testing service for PIDs and other immune-related disorders with a published sequence. Here we present results for this program, over the first decade, between 2005 and 2014. Results: We undertook testing in 228 index cases and 32 carriers during this time. The three most common test requests were for X-linked lymphoproliferative (XLP), tumour necrosis factor receptor associated periodic syndrome (TRAPS) and haemophagocytic lymphohistiocytosis (HLH). Of the 32 suspected XLP cases, positive diagnoses were established in only 2 patients. In contrast, genetic defects in 8 of 11 patients with suspected X-linked agammaglobu‑ linemia (XLA) were confirmed. Most XLA patients were initially identified from absence of B cells. Overall, positive diagnoses were made in about 23% of all tests requested. The diagnostic rate was lowest for several conditions with locus heterogeneity. Conclusions: Thorough clinical characterisation of patients can assist in prioritising which genes should be tested. The clinician-driven customised comprehensive genetic service has worked effectively for New Zealand. Next genera‑ tion sequencing will play an increasing role in disorders with locus heterogeneity.
    [Show full text]