Secondary Immunodeficiency: to Treat or not to Treat
Pediatric Department Faculty of Mecicine, Public Health and Nursing,
Universitas Gadjah Mada Yogyakarta Indonesia
Immunodeficiency results from a failure or absence of elements of the immune system. These immunodeficiencies can be either primary or secondary. A secondary immune deficiency (SID) disease occurs when the immune system is compromised due to an environmental factor or condition that occurs after birth. Examples of these outside forces include HIV, severe burns, malnutrition or chemotherapy.Some cancers can be responsible for SID, too. SID also occurs among critically ill, older, or hospitalized patients. Prolonged serious illness may impair immune responses, impairment is often reversible if the underlying illness resolves.
The signs and symptoms of SID are the same as for primary immunodeficiency; that is, frequent, prolonged or unusual infections. Tests are usually necessary to understand what the problem may be.Blood tests are used to test for SID. The precise tests of immune function will depend on the type of infections that have been a problem.
The treatment that will be recommended depends on the nature of the deficiency. If an ongoing treatment is thought to be the cause, then the treatment may be changed or removed. If another disease is the cause, then treating it may resolve the immunodeficiency. If the underlying cause can be removed, then in many individuals the immune system returns to normal. For others, this is not the case and the treatment is long term, even life-long. The immune system will be regularly monitored to determine to continuing treatment
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