Abstract
54 children, M:F=1:1, with recurrent respiratory infections and with normal sweat sodium, were screened for immunodeficiency, including serum immunoglobulins, nitroblue tetrazolium test, neutrophil and monocyte candida phagocytosis and killing, random locomotion and chemotaxis, and Saccharomyces opsonisation. 33 (61%) patients had at least one immune abnormality, including IgA deficiency 4%, opsonisation defect 19%, neutrophil or monocyte killing: serum dependent 30%, cell dependent 15%, and locomotor defect 26%. Some patients had more than one defect. Two patients with laevocardia and situs solitus had ciliary abnormalities, one transiently, and both had asthma but no immunodeficiency. There was no difference in the incidence of asthma in patients with and without immunodeficiency (17 of 33 v 14 of 21). Bacteria were isolated from sputum in 63% (34 of 54), the commonest organism being Haemophilus influenzae found in 52% with immunodeficiency and 38% without, whereas no difference was found for Pseudomonas (19%), Group A Streptococcus (20%) and Strep. pneumoniae (27%).
This demonstrates that significant immunological abnormalities are common in patients with recurrent chest infections, with or without asthma, and are much commoner than ciliary defects in cystic fibrosis or Kartagener's syndrome. Isolated opsonisation defects are uncommon and may only be clinically relevant if associated with other serum dependent defects of phagocytosis and/or killing.
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Sloper, K., Parkin, J., Bridges, J. et al. IMMUNODEFICIENCY IN CHILDREN WITH RECURRENT RESPIRATORY INFECTIONS. Pediatr Res 19, 1119 (1985). https://doi.org/10.1203/00006450-198510000-00285
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DOI: https://doi.org/10.1203/00006450-198510000-00285