[Secondary immunodeficiency as a consequence of chronic diseases]

Abstract

Secondary immunodeficiencies (SID) represents heterogeneous group of acquired impairment of immune system function with diverse etiology. It is mostly a combined disorder of both humoral and cellular component of the innate and adaptive immune response. SID occurs mainly in adulthood. Among the most important causes of SID development belong diabetes mellitus, impairment of liver and kidney functions, protein-energy malnutrition, splenic defects and immunosenescence. These deficiencies of immunity are clinically manifested by an increased frequency or unusual complications of common infections and occasionally by the occurrence of opportunistic infections. Diagnostic procedure is based on blood count and differential leukocyte count, biochemical examination, including determination of total protein and albumin concentrations, and biochemical urine analysis to eliminate protein losses. If clinically significant secondary defect of the immune system is suspected, immunological examination is indicated. Patients with clinical symptoms of SID can be treated with prophylactic antibiotic therapy, vaccination, substitution immunoglobulin therapy, or by immune system modifiers.

Keywords: diabetes mellitus; hyposplenism; immunosenescence; liver function impairment; malnutrition; renal function impairment; secondary immunodeficiency.