IMMUNODEFICIENT STATES IN PRETERM AND TERM INFANTS WITH RECURRENT RESPIRATORY DISEASES
Keywords:respiratory distress, Immunodeficiency, diagnostics, infant, preterm infant
Severe respiratory diseases are common manifestations of immunodeficiencies.The goal of our study is to reveal immunodeficient states in preterm infants with frequent severe respiratory diseases to improve management plans, prevent recurrences and minimize further lung damage.A case-control study was performed for 8 months. 53 preterm infants who had ARDS and were exposed to mechanical ventilation in the neonatal period, 6 of which showed CT scan abnormalities (fibrotic infiltrates, mosaic attenuation, ground-glass opacity), were compared to 32 term infants from the control group. Both groups presented with frequent severe respiratory diseases. IgG and IgA were deficient in 18 (33.96%) patients of the study group and 1 (3.125%) patient from the control group. The Fisher exact test statistic P-value is 0.0009.IVIG was transfused in 8 of the 18 preterm infants. During the next 3 to 7 months recurrence of the respiratory conditions was not reported in 6 (75%) patients; 1 (12.5%) patient experienced mild upper respiratory symptoms once, 1 (12.5%) patient was readmitted with respiratory failure. During 3 to 7 months at least one readmission was reported in 10 of 18 preterm patients who were not transfused IVIG.The research may reveal a correlation between frequent respiratory diseases and immunodeficiencies as either the cause or the result of the conditions in preterm babies, thus allowing us to improve management techniques to decrease recurrences and reduce further lung damage and readmission rates in the patients.
James Fernandez , MD, PhD, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Overview of Immunodeficiency Disorders, Apr 2021
Medically reviewed by Nancy Carteron, M.D., FACR — Written by Danielle Dresden — Updated on July 5, 2021
NORD gratefully acknowledges Charlotte Cunningham-Rundles, MD, PhD, Departments of Medicine, Pediatrics, The Prism Immunology Institute, The Icahn School of Medicine at Mount Sinai, for assistance in the preparation of this report., Common variable immune deficiency. (2020).
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