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Immunodeficiency
Presented by :-
Sher Khan
M.Sc. Ill Sem.
Department of Zoology
Shia P.G. College, Lucknow
Objectives
• Identify that Immunodeficiency is due to a defect in the
immune function.
• Describe the classification of Immunodeficiency.
• Explain the presentations of different types of Immuno-
deficiencies (e.g. recurrent infections).
• Understand the varieties of immune system deficiencies
involving defects in :
- T cells, B cells, phagocytes and complement.
• Know the laboratory investigations for
immunodeficiency disorders
Definition
• A state in which the ability of the
immune system to fight infectious
disease is compromised or entirely
absent
A person who has an immunodeficiency
is said to be immuno-compromised
Distribution of Primary
immunodeficiencies
Pattern of infections and symptoms associated
with primary immunodeficiencies
T-cell defects
- Absence or underdevelopment of the
Thymus gland (hypoplasia)
- Hypoparathyroidism
- Facial abnormalities
- Cardiovascular abnormalities
A congenital defect that is marked by:
DiGeorge Syndrome
(Congenital Thymic Aplasia )
Children may present with tetany
In the complete form:
- Extreme susceptibility to viral
protozoal, and fungal infections
- Profound depression of T-cell
numbers
- Absence of T-cell responses
Features of DiGeorge syndrome
Fetal thymus tissue graft
(14 weeks old)
Management of DiGeorge syndrome
B-cell defects
(Gammaglobulinaemias)
Patients with B-cell defects are subject to:
Recurrent bacterial infections
but
Display normal immunity to most viral
and fungal infections
Why ???
Diverse spectrum ranging from:
- Complete absence of B-cells
- Complete absence of plasma cells
- Low or absent immunoglobulins
- Selective absence of certain immunoglobulins
- Genetic Transmission
- Autosomal recessive
-X-linked disease:
Females : carriers (normal)
Males : manifest the disease
The most common type, 80 to 90 percent
Defect in Bruton Tyrosine Kinase (BTK)
The defect involves a block in maturation of pre-
B- cells to mature B-cells in bone marrow
X-linked agammaglobulinaemia (XLA) or
Bruton’s hypogammaglobulinaemia
(Congenital disease)
- Reduced B-cell counts to 0.1 percent
(normally 5-15 percent)
- Absence of Immunoglobulins
- Affected children suffer from recurrent
pyogenic bacterial infections
Features of XLA
IgA deficiency (1:700)
Most are asymptomatic: but may have
increased incidence of respiratory tract
infections (R.T.I)
Some have recurrent R.T.I and gastrointestinal
tract symptoms
Selective immunoglobulin deficiency
(Congenital disease)
Characterized by:
- Low IgG, IgA & IgE
- Variable IgM levels most
frequently high
X- linked hyper-IgM Syndrome
(Congenital disease)
Management of immunoglobulin
deficiencies:
*Periodic intravenous immunoglobulin
(IVIG) reduces infectious
complications
Severe Combined Immunodeficiency (SCID)
(Congenital disease)
Causes of SCID:
Enzyme deficiencies:
1. ADA (adenosine deaminase ) deficiency
2. PNP (purine phosphorylase) deficiency
Toxic metabolites accumulate in T and B cells
Features of SCID
- Increased susceptibility to :viral, fungal, bacterial
protozoal infections (starting at 3 months of age)
Management of SCID
1. Infusion of purified enzymes
2. Gene therapy
Leukocyte defects
Quantitative Qualitative
Congenital agranulocytosis:
Defect in the gene inducing G-CSF (granulocyte
colony stimulating factor)
Features:
Pneumonia, otitis media, abscesses
Quantitative Defects
A. Defect in chemotaxis
Leukocyte adhesion deficiency (LAD)
Defect: in the adhesion molecules responsible of
leukocyte trafficking and migration to sites of
infection
B. Defect in intracellular Killing
Chronic granulomatous disease:
Defect: in the oxidative complex responsible
for producing superoxide radicals
Qualitative Defects
(Congenital disease)
Chronic granulomatous disease (CGD)
(Congenital disease)
Neutrophils lack the "respiratory burst"
upon phagocytosis
- Characterized by recurrent life-
threatening bacterial and fungal
infections and granuloma formation
Complement Deficiency
Deficiency of all complement components
have been described C1-C9
Laboratory diagnosis of ID
1. Complete blood count : total & differential
2. Evaluation of antibody levels and response to
antigens
3. T and B cells counts (Flowcytometry)
4. Measurement of complement proteins and
function (CH50)
5. Assessment of phagocytosis and respiratory
burst (oxygen radicals)
Take Home Message
• Immunodeficiency may be congenital or
acquired
• It can involve any component of the immune
system such as cells, antibodies, complement
etc.
• Most common presentation of
immunodeficiency is recurrent infections that
may be fatal due to delay in diagnosis and lack
of appropriate therapy

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immunodeficiency

  • 1. Immunodeficiency Presented by :- Sher Khan M.Sc. Ill Sem. Department of Zoology Shia P.G. College, Lucknow
  • 2. Objectives • Identify that Immunodeficiency is due to a defect in the immune function. • Describe the classification of Immunodeficiency. • Explain the presentations of different types of Immuno- deficiencies (e.g. recurrent infections). • Understand the varieties of immune system deficiencies involving defects in : - T cells, B cells, phagocytes and complement. • Know the laboratory investigations for immunodeficiency disorders
  • 3. Definition • A state in which the ability of the immune system to fight infectious disease is compromised or entirely absent A person who has an immunodeficiency is said to be immuno-compromised
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  • 7. Pattern of infections and symptoms associated with primary immunodeficiencies
  • 9. - Absence or underdevelopment of the Thymus gland (hypoplasia) - Hypoparathyroidism - Facial abnormalities - Cardiovascular abnormalities A congenital defect that is marked by: DiGeorge Syndrome (Congenital Thymic Aplasia )
  • 10. Children may present with tetany In the complete form: - Extreme susceptibility to viral protozoal, and fungal infections - Profound depression of T-cell numbers - Absence of T-cell responses Features of DiGeorge syndrome
  • 11. Fetal thymus tissue graft (14 weeks old) Management of DiGeorge syndrome
  • 13. Patients with B-cell defects are subject to: Recurrent bacterial infections but Display normal immunity to most viral and fungal infections Why ???
  • 14. Diverse spectrum ranging from: - Complete absence of B-cells - Complete absence of plasma cells - Low or absent immunoglobulins - Selective absence of certain immunoglobulins - Genetic Transmission - Autosomal recessive -X-linked disease: Females : carriers (normal) Males : manifest the disease
  • 15. The most common type, 80 to 90 percent Defect in Bruton Tyrosine Kinase (BTK) The defect involves a block in maturation of pre- B- cells to mature B-cells in bone marrow X-linked agammaglobulinaemia (XLA) or Bruton’s hypogammaglobulinaemia (Congenital disease)
  • 16. - Reduced B-cell counts to 0.1 percent (normally 5-15 percent) - Absence of Immunoglobulins - Affected children suffer from recurrent pyogenic bacterial infections Features of XLA
  • 17. IgA deficiency (1:700) Most are asymptomatic: but may have increased incidence of respiratory tract infections (R.T.I) Some have recurrent R.T.I and gastrointestinal tract symptoms Selective immunoglobulin deficiency (Congenital disease)
  • 18. Characterized by: - Low IgG, IgA & IgE - Variable IgM levels most frequently high X- linked hyper-IgM Syndrome (Congenital disease)
  • 19. Management of immunoglobulin deficiencies: *Periodic intravenous immunoglobulin (IVIG) reduces infectious complications
  • 20. Severe Combined Immunodeficiency (SCID) (Congenital disease) Causes of SCID: Enzyme deficiencies: 1. ADA (adenosine deaminase ) deficiency 2. PNP (purine phosphorylase) deficiency Toxic metabolites accumulate in T and B cells
  • 21. Features of SCID - Increased susceptibility to :viral, fungal, bacterial protozoal infections (starting at 3 months of age)
  • 22. Management of SCID 1. Infusion of purified enzymes 2. Gene therapy
  • 24. Congenital agranulocytosis: Defect in the gene inducing G-CSF (granulocyte colony stimulating factor) Features: Pneumonia, otitis media, abscesses Quantitative Defects
  • 25. A. Defect in chemotaxis Leukocyte adhesion deficiency (LAD) Defect: in the adhesion molecules responsible of leukocyte trafficking and migration to sites of infection B. Defect in intracellular Killing Chronic granulomatous disease: Defect: in the oxidative complex responsible for producing superoxide radicals Qualitative Defects (Congenital disease)
  • 26. Chronic granulomatous disease (CGD) (Congenital disease) Neutrophils lack the "respiratory burst" upon phagocytosis - Characterized by recurrent life- threatening bacterial and fungal infections and granuloma formation
  • 28. Deficiency of all complement components have been described C1-C9
  • 29. Laboratory diagnosis of ID 1. Complete blood count : total & differential 2. Evaluation of antibody levels and response to antigens 3. T and B cells counts (Flowcytometry) 4. Measurement of complement proteins and function (CH50) 5. Assessment of phagocytosis and respiratory burst (oxygen radicals)
  • 30. Take Home Message • Immunodeficiency may be congenital or acquired • It can involve any component of the immune system such as cells, antibodies, complement etc. • Most common presentation of immunodeficiency is recurrent infections that may be fatal due to delay in diagnosis and lack of appropriate therapy