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. 2022 May 13:13:900055.
doi: 10.3389/fimmu.2022.900055. eCollection 2022.

Evaluation of the 10 Warning Signs in Primary and Secondary Immunodeficient Patients

Fadime Ceyda Eldeniz  1 , Yahya Gul  2 , Alaaddin Yorulmaz  3 , Sukru Nail Guner  2 , Sevgi Keles  2 , Ismail Reisli  2
Affiliations

Evaluation of the 10 Warning Signs in Primary and Secondary Immunodeficient Patients

Fadime Ceyda Eldeniz et al. Front Immunol. .

Abstract

Objectives: Ten warning signs of primary immunodeficiency (PID) were suggested by the Jeffrey Modell Foundation (JMF), to increase physician awareness of PID. These warning signs have not yet been evaluated for patients with secondary immunodeficiency (SID). This study investigated whether the 10 warning signs used for the diagnosis of PID were also sufficient for the diagnosis of SID, and explored the possibility of additional signs.

Methods: This prospective study was conducted between June and December 2020. The mothers of 162 patients with PID and SID, and mothers of 200 healthy children, were asked to complete a questionnaire about family and personal history in addition to the warning signs of PID developed by the JMF. A JMF score was created by giving one point for each "Yes" answer for the 10 warning signs of PID. Medical records of the patients were evaluated for possible additional warning signs for PID and SID.

Results: The JMF scores of the PID (3.36 ± 1.65) and SID (3.72 ± 1.12) groups were significantly higher than the scores of the control group (0.34 ± 0.61) (p < 0.05). A sign for immunological evaluation in two patients without warning signs in the PID group was found to be chronic diarrhea. In addition to the 10 JMF warning signs, we found that consanguinity and a family history of tuberculosis were statistically significant in our PID group, compared with the SID and control groups.

Conclusions: The JMF warning signs are important for early diagnosis of PID. Our study showed that these signs may also be used for the early diagnosis of SID in patients and, according to our results, in addition to the 10 JMF signs for PID, parental consanguinity, chronic diarrhea, and a family history of tuberculosis may also be considered warning signs for the early diagnosis of PID.

Keywords: 10 warning signs; childhood; combined immunodeficiency; primary immunodeficiency; secondary immunodeficiency.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The ROC curve for JMF score in the PID and SID groups.
Figure 2
Figure 2
The diagnosis of the patients with SID.
See this image and copyright information in PMC

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