Primary Immunodeficiency Patient Information
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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. -
Immunology in Pediatric Dentistry
PEDIATRIC DENTISTRY/Copynght© 1983 by The American Academy of Pedodontics/Vol. 5, No. 3 Immunology in pediatric dentistry William C. Donlon, DMD, MA Abstract The scope of clinical immunology is ever- usually are directed against a specific allergen and this increasing. A working knowledge of the immune substance will always invoke the same type of response system and its disease states is important in the although the severity may vary. Another variable is evalution and treatment of pediatric dental patients. whether the reaction is localized or generalized. This review focuses both on immune conditions with The antibody type which initiates the histamine- a possible iatrogenic origin, such as allergy, and releasing immediate atopic reaction is IgE. Molecule immune phenomena which the pedodontist may dimers of IgE adhere to most cells and basophils causing diagnose or treat as part of the medical team. degranulation and subsequent increase in extracellular levels of vasodilators such as histamine, slow-reacting substance - A, and the kinins. Clinical symptoms are "ue to advances in the science of immunology, pa- cutaneous wheal and flare, edema, rhinorrhea, tearing, tients with defects of the immune system are being possible respiratory embarrassment, and hypotension diagnosed earlier and living longer. The condition and/or (Figure 1). treatment modality may affect the patient's oral health Antihistamines are the most effective treatment in mild and delivery of dental care. On a more mundane level, cases. Active therapy of allergy may include induction of the pedodontist deals with the immune system daily when IgG antibody synthesis by multiple injections of minute inquiring about allergies and rheumatic fever in the quantities of the allergen. -
Our Immune System (Children's Book)
OurOur ImmuneImmune SystemSystem A story for children with primary immunodeficiency diseases Written by IMMUNE DEFICIENCY Sara LeBien FOUNDATION A note from the author The purpose of this book is to help young children who are immune deficient to better understand their immune system. What is a “B-cell,” a “T-cell,” an “immunoglobulin” or “IgG”? They hear doctors use these words, but what do they mean? With cheerful illustrations, Our Immune System explains how a normal immune system works and what treatments may be necessary when the system is deficient. In this second edition, a description of a new treatment has been included. I hope this book will enable these children and their families to explore together the immune system, and that it will help alleviate any confusion or fears they may have. Sara LeBien 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. SECOND EDITION COPYRIGHT 1990, 2007 IMMUNE DEFICIENCY FOUNDATION Copyright 2007 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. Our Immune System may not be resold, reprinted or redistributed for compensation of any kind without prior written permission from Immune Deficiency Foundation. If you have any questions about permission, please contact: Immune Deficiency Foundation, 40 West Chesapeake Avenue, Suite 308, Towson, MD 21204, USA; or by telephone at 1-800-296-4433. -
Ataxia..Telangiectasia and Cellular Responses to DNA Damage'
(CANCERRESEARCH55. 5991-6001. December 15, 19951 Review Ataxia..Telangiectasia and Cellular Responses to DNA Damage' M. Stephen Meyn2 Departments of Genetics and Pediatrics, Yale University School of Medicine, New Haven, connecticut 06510 Abstract elevated frequencies of spontaneous and induced chromosome aber rations, high spontaneous rates of intrachromosomal recombination, Ataxia-telangiectasia (A-T) is a human disease characterized by high aberrant immune gene rearrangements, and inability to arrest the cell cancer risk, immune defects, radiation sensitivity, and genetic instability. Although A-T homozygotes are rare, the A-T gene may play a role in cycle in response to DNA damage (3—6)]. sporadic breast cancer and other common cancers. Abnormalities of DNA The nature of the A-T defect has been the subject of much repair, genetic recombination, chromatin structure, and cell cycle check speculation; most hypotheses focus on the radiation sensitivity of point control have been proposed as the underlying defect in A-T; how A-T cells. Early reports that A-T fibroblasts were unable to excise ever, previous models cannot satisfactorily explain the plelotropic A-T radiation-induced DNA adducts prompted suggestions that the phenotype. radiation sensitivity of A-T cells was due to an intrinsic defect in Two recent observations help clarify the molecular pathology of A-T: DNA repair (7). However, subsequent work indicated that not all (a) inappropriate p53-mediated apoptosis is the major cause of death in A-T fibroblasts have a defect in DNA adduct excision (8), and that A-T cells irradiated in culture; and (b) ATM, the putative gene for A-T, has extensive homology to several celi cycle checkpoint genes from other the kinetics of repair of DNA breaks and chromosome aberrations organisms. -
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 -
Theory of an Immune System Retrovirus
Proc. Nati. Acad. Sci. USA Vol. 83, pp. 9159-9163, December 1986 Medical Sciences Theory of an immune system retrovirus (human immunodeficiency virus/acquired immune deficiency syndrome) LEON N COOPER Physics Department and Center for Neural Science, Brown University, Providence, RI 02912 Contributed by Leon N Cooper, July 23, 1986 ABSTRACT Human immunodeficiency virus (HIV; for- initiates clonal expansion, sustained by interleukin 2 and y merly known as human T-cell lymphotropic virus type interferon. Ill/lymphadenopathy-associated virus, HTLV-Ill/LAV), the I first give a brief sketch of these events in a linked- retrovirus that infects T4-positive (helper) T cells of the interaction model in which it is assumed that antigen-specific immune system, has been implicated as the agent responsible T cells must interact with the B-cell-processed virus to for the acquired immune deficiency syndrome. In this paper, initiate clonal expansion (2). I then assume that virus-specific I contrast the growth of a "normal" virus with what I call an antibody is the major component ofimmune system response immune system retrovirus: a retrovirus that attacks the T4- that limits virus spread. As will be seen, the details of these positive T cells of the immune system. I show that remarkable assumptions do not affect the qualitative features of my interactions with other infections as well as strong virus conclusions. concentration dependence are general properties of immune Linked-Interaction Model for Clonal Expansion of Lympho- system retroviruses. Some of the consequences of these ideas cytes. Let X be the concentration of normal infecting virus are compared with observations. -
Cells, Tissues and Organs of the Immune System
Immune Cells and Organs Bonnie Hylander, Ph.D. Aug 29, 2014 Dept of Immunology [email protected] Immune system Purpose/function? • First line of defense= epithelial integrity= skin, mucosal surfaces • Defense against pathogens – Inside cells= kill the infected cell (Viruses) – Systemic= kill- Bacteria, Fungi, Parasites • Two phases of response – Handle the acute infection, keep it from spreading – Prevent future infections We didn’t know…. • What triggers innate immunity- • What mediates communication between innate and adaptive immunity- Bruce A. Beutler Jules A. Hoffmann Ralph M. Steinman Jules A. Hoffmann Bruce A. Beutler Ralph M. Steinman 1996 (fruit flies) 1998 (mice) 1973 Discovered receptor proteins that can Discovered dendritic recognize bacteria and other microorganisms cells “the conductors of as they enter the body, and activate the first the immune system”. line of defense in the immune system, known DC’s activate T-cells as innate immunity. The Immune System “Although the lymphoid system consists of various separate tissues and organs, it functions as a single entity. This is mainly because its principal cellular constituents, lymphocytes, are intrinsically mobile and continuously recirculate in large number between the blood and the lymph by way of the secondary lymphoid tissues… where antigens and antigen-presenting cells are selectively localized.” -Masayuki, Nat Rev Immuno. May 2004 Not all who wander are lost….. Tolkien Lord of the Rings …..some are searching Overview of the Immune System Immune System • Cells – Innate response- several cell types – Adaptive (specific) response- lymphocytes • Organs – Primary where lymphocytes develop/mature – Secondary where mature lymphocytes and antigen presenting cells interact to initiate a specific immune response • Circulatory system- blood • Lymphatic system- lymph Cells= Leukocytes= white blood cells Plasma- with anticoagulant Granulocytes Serum- after coagulation 1. -
Agammaglobulinemia Hypogammaglobulinemia Hereditary Disease Immunoglobulins
Pediat. Res. 2: 72-84 (1968) Agammaglobulinemia hypogammaglobulinemia hereditary disease immunoglobulins Hereditary Alterations in the Immune Response: Coexistence of 'Agammaglobulinemia', Acquired Hypogammaglobulinemia and Selective Immunoglobulin Deficiency in a Sibship REBECCA H. BUCKLEY[75] and J. B. SIDBURY, Jr. Departments of Pediatrics, Microbiology and Immunology, Division of Immunology, Duke University School of Medicine, Durham, North Carolina, USA Extract A longitudinal immunologic study was conducted in a family in which an entire sibship of three males was unduly susceptible to infection. The oldest boy's history of repeated severe infections be- ginning in infancy and his marked deficiencies of all three major immunoglobulins were compatible with a clinical diagnosis of congenital 'agammaglobulinemia' (table I, fig. 1). Recurrent severe in- fections in the second boy did not begin until late childhood, and his serum abnormality involved deficiencies of only two of the major immunoglobulin fractions, IgG and IgM (table I, fig. 1). This phenotype of selective immunoglobulin deficiency is previously unreported. Serum concentrations of the three immunoglobulins in the youngest boy (who also had a late onset of repeated infection) were normal or elevated when he was first studied, but a marked decline in levels of each of these fractions was observed over a four-year period (table I, fig. 1). We could find no previous reports describing apparent congenital and acquired immunologic deficiencies in a sibship. Repeated infections and demonstrated specific immunologic unresponsiveness preceded gross ab- normalities in the total and fractional gamma globulin levels in both of the younger boys (tables II-IV). When the total immunoglobulin level in the second boy was 735 mg/100 ml, he failed to respond with a normal rise in titer after immunization with 'A' and 'B' blood group substances, diphtheria, tetanus, or Types I and II poliovaccines. -
Chapter 2 Agammaglobulinemia: X-Linked and Autosomal Recessive
Agammaglobulinemia: X-Linked and Autosomal Recessive Chapter 2 Agammaglobulinemia: X-Linked and Autosomal Recessive The basic defect in both X-Linked Agammaglobulinemia and autosomal recessive agammaglobulinemia is a failure of B-lymphocyte precursors to mature into B-lymphocytes and ultimately plasma cells. Since they lack the cells that are responsible for producing immunoglobulins, these patients have severe deficiencies of all types of immunoglobulins. Definition of X-Linked Agammaglobulinemia (XLA) and Autosomal Recessive Agammaglobulinemia (ARA) X-Linked Agammaglobulinemia (XLA) was first are not coated with antibody. All of these actions described in 1952 by Dr. Ogden Bruton. This disease, prevent germs from invading body tissues where they sometimes called Bruton’s Agammaglobulinemia or may cause serious infections. (See chapter titled “The Congenital Agammaglobulinemia, was one of the first Immune System and Primary Immunodeficiency immunodeficiency diseases to be identified. XLA is an Diseases.”) inherited immunodeficiency disease in which patients The basic defect in XLA is an inability of the patient to lack the ability to produce antibodies, the proteins that produce antibodies. Antibodies are produced by make up the gamma globulin or immunoglobulin specialized cells in the body, called plasma cells. fraction of blood plasma. Plasma cells develop in an orderly sequence of steps Antibodies are an integral part of the body’s defense beginning with stem cells located in the bone marrow. mechanism against certain types of microorganisms or The stem cells give rise to immature lymphocytes, germs, like bacteria or viruses. Antibodies are important called pro-B-lymphocytes. Pro-B-lymphocytes next in the recovery from infections and protect against develop into pre-B-cells, which then give rise to getting certain infections more than once. -
Ataxia Telangiectasia: a Diagnostic Challenge. Case Report
case reports 2020; 6(2) https://doi.org/10.15446/cr.v6n2.83219 ATAXIA TELANGIECTASIA: A DIAGNOSTIC CHALLENGE. CASE REPORT Keywords: Ataxia Telangiectasia; Neurodegenerative Diseases; Cerebellar Ataxia; Spinocerebellar Degenerations; Telangiectasia. Palabras clave: Ataxia telangiectasia; Enfermedades neurodegenerativas; Ataxia cerebelosa; Degeneraciones espinocerebelosa; Telangiectasia. Natalia Martínez-Córdoba Universidad Militar Nueva Granada - Faculty of Medicine - Pediatric Neurology Research Group - Bogotá D.C. - Colombia. Hospital Militar Central - Pediatric Neurology Service - Bogotá D.C. - Colombia. Eugenia Espinosa-García Universidad Militar Nueva Granada - Faculty of Medicine - Pediatric Neurology Research Group - Bogotá D.C. - Colombia. Hospital Militar Central - Pediatric Neurology Service - Bogotá D.C. - Colombia. Universidad del Rosario - Medical School - Bogotá D.C. - Colombia. Corresponding author Natalia Martínez-Córdoba. Faculty of Medicine, Universidad Militar Nueva Granada. Bogotá D.C. Colombia. Email: [email protected]. Received: 28/10/2019 Accepted: 08/01/2020 case reports Vol. 6 No. 2: 109-17 110 RESUMEN ABSTRACT Introducción. La ataxia-telangiectasia (AT) es Introduction: Ataxia-telangiectasia (AT) is a un síndrome neurodegenerativo con baja inciden- neurodegenerative syndrome with low incidence cia y prevalencia mundial que es causado por una and prevalence worldwide, which is caused by a mutación del gen ATM, es de herencia autosó- mutation of the ATM gene. It is an autosomal re- mica recesiva y se asocia a mecanismos defec- cessive disorder that is associated with defective tuosos en la regeneración y reparación del ADN. cell regeneration and DNA repair mechanisms. It Este síndrome se caracteriza por la presencia de is characterized by progressive cerebellar atax- ataxia cerebelosa progresiva, movimientos ocula- ia, abnormal eye movements, oculocutaneous res anormales, telangiectasias oculocutáneas e telangiectasias and immunodeficiency. -
Practice Parameter for the Diagnosis and Management of Primary Immunodeficiency
Practice parameter Practice parameter for the diagnosis and management of primary immunodeficiency Francisco A. Bonilla, MD, PhD, David A. Khan, MD, Zuhair K. Ballas, MD, Javier Chinen, MD, PhD, Michael M. Frank, MD, Joyce T. Hsu, MD, Michael Keller, MD, Lisa J. Kobrynski, MD, Hirsh D. Komarow, MD, Bruce Mazer, MD, Robert P. Nelson, Jr, MD, Jordan S. Orange, MD, PhD, John M. Routes, MD, William T. Shearer, MD, PhD, Ricardo U. Sorensen, MD, James W. Verbsky, MD, PhD, David I. Bernstein, MD, Joann Blessing-Moore, MD, David Lang, MD, Richard A. Nicklas, MD, John Oppenheimer, MD, Jay M. Portnoy, MD, Christopher R. Randolph, MD, Diane Schuller, MD, Sheldon L. Spector, MD, Stephen Tilles, MD, Dana Wallace, MD Chief Editor: Francisco A. Bonilla, MD, PhD Co-Editor: David A. Khan, MD Members of the Joint Task Force on Practice Parameters: David I. Bernstein, MD, Joann Blessing-Moore, MD, David Khan, MD, David Lang, MD, Richard A. Nicklas, MD, John Oppenheimer, MD, Jay M. Portnoy, MD, Christopher R. Randolph, MD, Diane Schuller, MD, Sheldon L. Spector, MD, Stephen Tilles, MD, Dana Wallace, MD Primary Immunodeficiency Workgroup: Chairman: Francisco A. Bonilla, MD, PhD Members: Zuhair K. Ballas, MD, Javier Chinen, MD, PhD, Michael M. Frank, MD, Joyce T. Hsu, MD, Michael Keller, MD, Lisa J. Kobrynski, MD, Hirsh D. Komarow, MD, Bruce Mazer, MD, Robert P. Nelson, Jr, MD, Jordan S. Orange, MD, PhD, John M. Routes, MD, William T. Shearer, MD, PhD, Ricardo U. Sorensen, MD, James W. Verbsky, MD, PhD GlaxoSmithKline, Merck, and Aerocrine; has received payment for lectures from Genentech/ These parameters were developed by the Joint Task Force on Practice Parameters, representing Novartis, GlaxoSmithKline, and Merck; and has received research support from Genentech/ the American Academy of Allergy, Asthma & Immunology; the American College of Novartis and Merck. -
Primary Immunodeficiency Disorders
ALLERGY AND IMMUNOLOGY 00954543 /98 $8.00 + .OO PRIMARY IMMUNODEFICIENCY DISORDERS Robert J. Mamlok, MD Immunodeficiency is a common thought among both patients and physicians when confronted with what is perceived as an excessive num- ber, duration, or severity of infections. Because of this, the starting point for evaluating patients for suspected immunodeficiency is based on what constitutes ”too many infections.” It generally is agreed that children with normal immune systems may have an average of 6 to 8 respiratory tract infections per year for the first decade of life. Even after a pattern of ab- normal infection is established, questions of secondary immunodeficiency should first be raised. The relatively uncommon primary immunodefi- ciency diseases are statistically dwarfed by secondary causes of recurrent infection, such as malnutrition, respiratory allergy, chronic cardiovascular, pulmonary, and renal disease, and environmental factors. On the other hand, a dizzying spiral of progress in our understanding of the genetics and immunology of primary immunodeficiency disease has resulted in improved diagnostic and therapeutic tools. Twenty-five newly recognized immunologic disease genes have been cloned in the last 5 ~ears.2~It has become arguably more important than ever for us to recognize the clinical and laboratory features of these relatively uncommon, but increasingly treatable, disorders. CLASSIFICATION The immune system has been classically divided into four separate arms: The B-cell system responsible for antibody formation, the T-cell sys- From the Division of Pediatric Allergy and Immunology, Texas Tech University Health Sci- ences Center, Lubbock, Texas PRIMARY CARE VOLUME 25 NUMBER 4 DECEMBER 1998 739 740 MAMLOK tem responsible for immune cellular regulation, the phagocytic (poly- morphonuclear and mononuclear) system and the complement (opsonic) system.