Jahnz-RÓŻyk Karina, WiĘsik-Szewczyk Ewa, RoliŃski Jacek, Siedlar Maciej, JĘdrzejczak WiesŁaw, Sydor Wojciech, Tomaszewska Agnieszka
Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Warsaw, Poland.
Department of Clinical Immunology, Medical University of Lublin, Lublin, Poland.
Cent Eur J Immunol. 2020;45(3):334-341. doi: 10.5114/ceji.2020.101265. Epub 2020 Nov 1.
At present, secondary immune deficiencies have become a clinical problem, recognized in different specialties. The aim of this paper was to increase awareness and support the need for screening at-risk populations. Secondary immune deficiencies result in variety of conditions, but not all of them require immunoglobulin replacement therapy, as specific antibody response might be preserved. Moreover, the management of secondary immune deficiencies vary between countries and different medical disciplines. This literature review presents the most common causes and clinical presentation of secondary immunodeficiencies with predominant impaired antibody production. We present diagnostic guidelines for patients at-risk, with an emphasis on the role of prophylactic vaccination as a treatment and diagnostic tool. This review considers the specificity and disparities of the Polish healthcare system and ultimately, suggests that management teams should include a clinical immunologist experienced in the treatment of humoral immunodeficiencies.
目前，继发性免疫缺陷已成为一个临床问题，在不同专业领域都得到了认可。本文的目的是提高认识并支持对高危人群进行筛查的必要性。继发性免疫缺陷会导致多种病症，但并非所有病症都需要免疫球蛋白替代疗法，因为特异性抗体反应可能得以保留。此外，继发性免疫缺陷的管理在不同国家和不同医学学科之间存在差异。这篇文献综述介绍了以抗体产生主要受损为特征的继发性免疫缺陷的最常见病因和临床表现。我们为高危患者提供了诊断指南，重点强调了预防性疫苗接种作为一种治疗和诊断工具的作用。本综述考虑了波兰医疗保健系统的特殊性和差异，最终建议管理团队应包括一位在体液免疫缺陷治疗方面经验丰富的临床免疫学家。
