IMMUNOLOGY TEXTBOOK - Mercury Podillia 2013

ACQUIRED IMMUNODEFICIENCY STATES

Diagnosis of Secondary Immunodeficiencies

The First stage of Diagnosis involves Taking the patient's medical history and assessing their Complaints, which can vary significantly depending on the type of immunodeficiency.

In cases of immunodeficiency, the medical history typically reveals recurrent infections, The Nature and localization of which may point to the specific type of immune defect. Allergic conditions have their own distinct features, and a proper diagnosis can sometimes be established solely on The basis of the medical history.

The clinical history in autoimmune diseases has characteristic features that help differentiate them from other pathologies. Lymphoproliferative and oncological processes also display distinctive signs. The next stage involves conducting immunological tests to evaluate the immune status of a patient with suspected immunodeficiency.

«Immune status» refers to the condition of The Immune System in a healthy or sick individual at a specific point in time under particular environmental conditions.

Immunological, or immune status (IS), is characterized by a set of informative parameters reflecting the condition of various Components of the immune system at the time of examination in the context of a specific process or disease. Assessing immune status is The process of obtaining a set of nonspecific and specific quantitative and functional indicators that reflect the state of the immune system. By illustrating the form and variant of a disease, immune status parameters serve as the basis for creating an immunological "profile" of the illness—that is, its immunological characterization and the identification of the defective immune component.

Immunodiagnostics is the application of a set of immunological Methods to detect a disease or identify a pathogen in a studied sample. All Immunodiagnostic Methods are divided into 2 groups:

- general nonspecific methods that characterize the state of various components of the immune system: lymphocytes, granulocytes, macrophages, and Complement. They are typically used to detect a defect in the immune system, i.e., in immunodeficiencies;

- Structure/129.html">Specific methods that allow for the detection of Antibodies, immune T-lymphocytes, and pathogen Antigens in The Human Body or the external environment. These methods are used to diagnose infections, allergies, and autoimmune diseases.

The diagnostic standard for Secondary Immunodeficiency States comprises the following examinations.

1. Mandatory laboratory evaluation:

✵ investigation of immune status (determination of total leukocyte count, lymphocyte count, T-lymphocyte subpopulations, B-lymphocytes, levels of IMMUNOGLOBULINS A, M, G, and phagocytosis);

✵ monitoring of detected abnormalities following a course of therapy.

2. Additional Diagnostic Methods:

✵ special immunological tests depending on clinical manifestations and defects identified during the initial immune status assessment, such as examining the functional activity of lymphocyte classes and subclasses, hemolytic activity of The Complement System, nonspecific acute-phase indicators, interferon status, immune control of opportunistic infections, etc.;

✵ instrumental Diagnostics;

✵ specialist consultations.

Main Features of secondary immunodeficiencies:

- absence of any link to heredity and genetic predisposition;

- onset against the Background of normal reactivity due to disease, METABOLISM/18.html">The Influence of adverse physical and biological factors, or specific treatments and remedies;

- persistence of the deficiency despite treating the underlying disease and eliminating the factors that induced it;

- absence or prolonged delay in the normalization of immune status.

The characteristics of immune status disorders in secondary immunodeficiencies are presented in Table 70.

Class="center">Table 70. Characteristics of secondary immunodeficiencies

Note: (+) - increase, (-) - decrease in the index.