Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, CSIC, University of Seville, Seville, Spain; Department of Medicine, University of Seville, Seville, Spain.
Paediatric Infectious Diseases, Rheumatology and Immunology Unit, University Hospital Virgen del Rocio, Institute of Biomedicine, Seville, Spain.
J Allergy Clin Immunol Pract. 2020 Nov-Dec;8(10):3342-3347. doi: 10.1016/j.jaip.2020.05.008.
Primary immunodeficiencies (PIDs) are rare, undiagnosed and potentially fatal diseases. Clinical manifestations of PID can be fatal or leave sequelae that worsen the quality of life of patients. Traditionally, the treatment of PIDs has been largely supportive, with the exception of bone marrow transplantation and, more recently, gene therapy. The discovering of new affected pathways, the development of new molecules and biologics, and the increasing understanding of the molecular basis of these disorders have created opportunities in PIDs therapy. This document aims to review current knowledge and to provide recommendations about the diagnosis and clinical management of adults and children with PIDs based on the available scientific evidence taking in to account current practice and future challenges. A systematic review was conducted, and evidence levels based on the available literature are given for each recommendation where available.
原发性免疫缺陷病(PID)是罕见的、未被诊断的、潜在致命的疾病。PID 的临床表现可能致命,或留下后遗症,使患者的生活质量恶化。传统上,PID 的治疗主要是支持性的,除了骨髓移植,最近还有基因治疗。新的受影响途径的发现、新分子和生物制剂的开发,以及对这些疾病分子基础的理解不断加深,为 PID 治疗带来了机会。本文件旨在回顾当前的知识,并根据现有科学证据,结合当前的实践和未来的挑战,就 PID 患者的诊断和临床管理提出建议。进行了系统评价,并在有可用文献的情况下,为每项建议提供了基于现有文献的证据水平。