Primary immunodeficiency diseases in lung disease: warning signs, diagnosis and management

Respir Res. 2018 Nov 12;19(1):219. doi: 10.1186/s12931-018-0923-8.

Abstract

Background: Pulmonary complications are common in primary immunodeficiency diseases (PID) and contribute to morbidity and mortality in these patients. However, their varied presentation and a general lack of awareness of PID in this setting make early diagnosis and treatment difficult. The aim of this study was to define the warning signs of PID in patients with respiratory manifestations, the necessary diagnostic tests, and the therapeutic management of both children and adults.

Methods: A review of the literature was performed, and 43 PID interdisciplinary specialists were consulted.

Results: This document identifies the pulmonary and extrapulmonary manifestations that should prompt a suspicion of PID, the immunological and respiratory tests that should be included in the diagnostic process according to the level of care, recommendations regarding the use of immunoglobulin replacement therapy according to the specific immunodeficiency, and the minimum recommended immunological and pulmonary monitoring in these patients.

Conclusions: This document is the first to combine scientific evidence with the opinion of a broad panel of experts specializing in the treatment of patients with immunodeficiencies. It aims to provide a useful tool for all practitioners who are regularly involved in the management of these patients.

Keywords: “Antibodies/deficiency”[mesh]; “Immunoglobulins/administration and dosage”[mesh]; “Immunoglobulins/deficiency”[mesh]; “Immunologic Deficiency Syndromes”[mesh]; “Respiratory Tract Infections”[mesh].

Publication types

  • Review

MeSH terms

  • Disease Management*
  • Expert Testimony / methods
  • Expert Testimony / trends
  • Humans
  • Immunologic Deficiency Syndromes / diagnosis*
  • Immunologic Deficiency Syndromes / epidemiology
  • Immunologic Deficiency Syndromes / therapy*
  • Lung Diseases / diagnosis*
  • Lung Diseases / epidemiology
  • Lung Diseases / therapy*