IP-10 Monocytes, macrophages, Chemokine for activated T cells, monocytes, and NK cells endothelium
IFN, Interferon; NK, natural killer; RANTES, regulated on activation, normal T expressed and secreted; Th2, T helper 2.
Recurrent pyogenic infections with extracellular encapsulated organisms, such as Streptococcus pneumoniae, Haemophilus influenzae type b, and group A streptococcus
Otitis, sinusitis, recurrent pneumonia, bronchiectasis, and conjunctivitis
Few problems with fungal or viral infections (except enterovirus and poliomyelitis)
Diarrhea common, especially secondary to infection with Giardia lamblia
Compatible with survival to adulthood or for several years after onset unless complications occur
Recurrent bacterial infections with extracellular encapsulated organisms, such as S. pneumoniae and H. influenzae Susceptibility to recurrent infections with Neisseria meningitides Increased incidence of autoimmune disease Severe or recurrent skin and respiratory tract infection
Recurrent infections with less virulent or opportunistic organisms, such as fungi, Candida sp mycobacteria, viruses, and protozoa as well as bacteria
Growth retardation, malabsorption, diarrhea, and failure to thrive common
Anergy Susceptible to graft-versus-host disease from nonirradiated blood or from maternal engraftment
Fatal reactions may occur from live virus or bacille Calmette-Guérin vaccination. High incidence of malignancy Poor survival beyond infancy or early childhood
Recurrent dermatologic infections with bacteria such as Staphylococcus, Pseudomonas, and Escherichia coli, and fungi such as Aspergillus
Subcutaneous, lymph node, lung, and liver abscesses Pulmonary infections common, including abscess and pneumatocele formation, contributing to chronic disease
Delayed separation of umbilical cord
Absence of pus at site(s) of infection Poor wound healing in life. The presence of associated problems, such as congenital heart disease and hypocalcemia (DiGeorge syndrome),abnormal gait and telangiectasia (Ataxia-telangiectasia),atopic dermatitis (hyper-IgE syndrome, Omenn syndrome),and easy bruising or a bleeding disorder (Wiskott-Aldrichsyndrome) can be informative in guiding an immune workup.Finally a family history of a primary immune deficiency or death of a young child due to infections should prompt an immune evaluation, particularly in the setting of recurrentinfections.
Immunosuppressive agents (e.g., corticosteroids, radiation, and antimetabolites) Malignancy (leukemia, Hodgkin disease, nonlymphoid cancer) Acquired asplenia Acquired neutropenia (autoimmune, viral, or drug-induced) Stem cell transplantation/graft-versus-host disease Systemic lupus erythematosus and other autoimmune diseases Sarcoidosis