Allerji Kliniğinde İzlenen Hastalarda Primer Antikor Eksiklikleri

Abstract

Amaç: Bu çalışmada, allerji kliniğinde değerlendirilen ve primer antikor eksikliği saptanan hastalarımızın klinik ve demografi k özelliklerinin belirlenmesi amaçlanmıştır. Materyal-Metod: Çocuk Allerji Kliniğinde Eylül 2007-Ağustos 2010 tarihleri arasında takip edilen 4600 hastanın dosya kayıtları eşlik eden primer antikor eksikliği açısından incelendi. Bulgular: Hastalarımızın 97’sinde (%2.1) primer antikor eksikliği saptanmıştı. 97 hastanın 74’ü (%76.3) erkek idi (yaş aralığı: 13-204 ay). %21.6’sında anne ve baba arasında akrabalık ve %4.1’inin ailesinde immun yetmezlik öyküsü vardı.Hastaların tanıları: 62’si (%63.9) geçici hipogamaglobulinemi, 21’i (%21.6) IgA eksikliği, 6’sı (%6.2) IgG alt grup eksikliği ve 8’i (%8.2) IgM eksikliği idi. Hastaların allerji bölümünde izlendikleri tanılar; 63’ü astım, 18’i hışıltılı bebek, 6’sı ürtiker, 4’ü allerjik rinit, 4’ü atopik egzema ve 2’si besin alerjisi idi. Sonuç: İmmün yetmezlikler allerjik hastalıklar ile birarada olabilmektedir. Hastaları değerlendirirken bu hastalıklar da göz önünde bulundurulmalıdır.

Keywords

• Allerjik hastalıklar, astım, çocuk, immün yetmezlikler, IgA eksikliği

PRIMARY ANTIBODY DEFICIENCIES IN PATIENTS WHO ARE FOLLOWING AT ALLERGY DEPARTMENT

Abstract

Aim: The aim of this study is to evaluate the clinical and demographic characteristics of patients with antibody defi ciency in our allergy clinic. Material-Method: The medical records of 4600 patients attended to our allergy outpatient clinic between September 2007 and August 2010 were reviewed for accompanying primary antibody defi ciencies.Results: Ninety-seven (2.1%) of the patients had primary antibody defi ciency. Of these 97 patients, 74 (76.3%) were male (age range: 13-204 months), 21.6 % had parental consanguinity and 4.1% had a family history of immune-defi ciency.The diagnosis of patients were as follows: 62 (63.9%) transient hypogamaglobulinemia, 21 (21.6%) IgA defi ciency, 6 (6.2%) IgG subclass defi ciency, and 8 (8.2%) IgM defi ciency. Their diagnosis in allergy clinic were; 63 asthma, 18 wheezy infant, 6 urticaria, 4 allergic rhinitis, 4 atopic dermatitis, and 2 food allergy. Conclusion: Primary antibody defi ciencies can be seen together with allergic diseases. During evaluation of allergic patients, primary immune defi ciencies should also be considered

Keywords

• Allergic disease, asthma, children, immun-defi ciency, IgA defi ciency

References

1. Buckley RB. Primary Immunodeficiency Diseases. In: Adkinson NF, Holgate ST, Bochner BS, Lemanske RF, Buse W, Simons FE (eds). Middleton’s Allergy Principles and Practice. 7th ed. China, Elsevier, 2009:801-829.
2. Camcıoğlu Y. Primer İmmün yetersizlikli çocukta allerji. Güncel Pediatri 2005;3: 124-125.
3. İkincioğulları A. B Hücre Yetmezlikli Hasta Kliniği. Güncel Pediatri 2006;4:88.
4. Farhoudi A, Aghamohammadi A, Moin M, Rezaei N, Pourpak Z, Movahedi M, Gharagozlou M, Amir Tahaei S, MirSaeid Ghazi B, Mahmoudi M, Kouhi A, Atarod L, Ahmadi Afshar A, Bazargan N, Isaeian A. Distribution of primary immunodeficiency disorders di- agnosed in the Children’s Medical Center in Iran. J Invest Allergol Clin Immunol 2005; 15: 177-182.
5. Reda SM, Afifi HM, Amine MM. Primary Immunodeficiency Diseases in Egyptian Children: A Single-Center Study. J Clin Immunol 2009; 29:343–351.
6. Ochs HD, Stiehm ER, Winkelstein JA. Antibody deficienci- es. In:Stiehm ER, Ochs HD, Winkelstein JA (eds).Immunologic Disorders in Infants&Children. 5th ed..Philadelphia, Elsevier, 2004:356-426.
7. Aksu G, Genel F, Koturoğlu G, Kurugöl Z, Kütükçüler N. Serum immunoglobulin (IgG, IgM, IgA) and IgG subclass concentrations in healthy children: a study using nephelometric technique. Turk J Pediatr. 2006 ;48:19-24.
8. GINA Report, Global Strategy for Asthma Management and Prevention. Updated December 2009. www.ginasthma.com/ GuidelinesResources.asp

9. Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ, Schachner LA, Sidbury R, Whitmore SE, Sieck CK, Van Voorhees AS. Guidelines of care for atopic dermatitis developed in accordance with the American Academy of Dermatology (AAD)/ American Academy of Dermatology Association “Administrative Regulations for Evidence-Based Clinical Practice Guidelines”. J Am Acad Dermatol 2004; 50: 391-404.
10. Roxo Jşnior P. Primary immunodeficiency diseases: relevant as- pects for pulmonologists. J Bras Pneumol. 2009;35: 1008-1017.
11. Yorulmaz A, Artaç H, Kara R, Reisli İ. Primer İmmün yetmez- likli 1054 olgunun retrospektif değerlendirilmesi. Astım Allerji İmmünoloji 2008; 6: 127-134.
12. Genel F, Can D, Yılmaz N ve ark. Antikor eksikliği olan çocuklar- da alerji sıklığı. Astım Alerji İmmünoloji 2009; 7: 174-179.
13. Aghamohammadi A, Cheraghi T, Gharagozlou M, Movahedi M, Rezaei N, Yeganeh M, Parvaneh N, Abolhassani H, Pourpak Z, Moin M. IgA deficiency:correlation betweeen clinical and immu- nological phenotypes. J Clin Immunol 2009;29: 130-136.
14. Goldstein MF, Goldstein AL, Dunsky EH, Dvorin DJ, Belecanech GA, Shamir K. Pediatric selective IgM immunodeficiency. Clin Dev Immunol 2008;2008:624850.
15. de Moraes Lui C, Oliveria LC, Diogo CL, Kirschfink M, Grumach AS. Immunoglobulin G subclass concentrations and infections in children and adolesents with severe asthma. Pediatr Allergy and Immunol 2002;13:195-202.