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Review
. 2012 Jan;167(1):108-19.
doi: 10.1111/j.1365-2249.2011.04461.x.

Patient-centred screening for primary immunodeficiency, a multi-stage diagnostic protocol designed for non-immunologists: 2011 update

E de Vries  1 ; European Society for Immunodeficiencies (ESID) members
Collaborators, Affiliations
Review

Patient-centred screening for primary immunodeficiency, a multi-stage diagnostic protocol designed for non-immunologists: 2011 update

E de Vries et al. Clin Exp Immunol. 2012 Jan.

Abstract

Members of the European Society for Immunodeficiencies (ESID) and other colleagues have updated the multi-stage expert-opinion-based diagnostic protocol for non-immunologists incorporating newly defined primary immunodeficiency diseases (PIDs). The protocol presented here aims to increase the awareness of PIDs among doctors working in different fields. Prompt identification of PID is important for prognosis, but this may not be an easy task. The protocol therefore starts from the clinical presentation of the patient. Because PIDs may present at all ages, this protocol is aimed at both adult and paediatric physicians. The multi-stage design allows cost-effective screening for PID of the large number of potential cases in the early phases, with more expensive tests reserved for definitive classification in collaboration with a specialist in the field of immunodeficiency at a later stage.

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Figures

Fig. 1
Fig. 1
Protocol 1. ANA: anti-nuclear antibody; C: complement; CD: cluster of differentiation; Ig: immunoglobulin; MBL: mannose binding lectin; PID: primary immunodeficiency. Grey shading: consultation with an immunologist is highly recommended.
Fig. 2
Fig. 2
Protocol 2. ADA: adenosine deaminase; AIDS: acquired immunodeficiency syndrome; BAL: bronchoalveolar lavage; CD: cluster of differentiation; HIV: human immunodeficiency virus; Ig: immunoglobulin; IFN: interferon; IL: interleukin; NK: natural killer; PID: primary immunodeficiency; PNP: purine nucleoside phosphorylase; PPD: purified protein derivative; SCID: severe combined immunodeficiency; SCT: stem cell transplantation; STAT: signal transducers and activators of transcription. Grey shading: consultation with an immunologist is highly recommended.
Fig. 3
Fig. 3
Protocol 3. ANA: anti-nuclear antibody; ANCA: anti-neutrophil cytoplasmic antibodies; C: complement component; CD: cluster of differentiation; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; GCSF: granulocyte–colony-stimulating factor; Ig: immunoglobulin; RF: rheumatoid factor; sLeX: sialyl-Lewis X. Grey shading: consultation with an immunologist is highly recommended.
See this image and copyright information in PMC

References

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