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Does the frequency of respiratory tract infections help to identify humoral immunodeficiencies in a primary health-care cohort?
Ryhov County Hospital, Jönköping, Sweden.
Ryhov County Hospital, Jönköping, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
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2015 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 47, no 1, 13-19 p.Article in journal (Refereed) Published
Abstract [en]

Background: Primary immune deficiency (PID) due to humoral defects is associated with recurrent respiratory tract infections (RTIs). Reliable clinical warning signs of PID would facilitate early diagnosis and thereby reduce long-term complications. The aim of the present study was to evaluate the accuracy of the warning sign, 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years,' for detecting PID among adults in a primary health-care setting. Methods: Fifty-three cases with 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years' were selected from a Swedish primary health-care registry of RTIs. In addition, 66 age- and sex-matched controls were selected having a maximum of one antibiotic-treated RTI during the period covered by the study. Levels of immunoglobulin (Ig) IgG, IgA, IgM, IgG subclasses, and IgG antibodies against Haemophilus influenzae and Streptococcus pneumoniae as well as the inflammatory markers, C-reactive protein, interleukin (IL)-6 and IL-8 were determined. Results: IgG subclass deficiencies (IgGsd) were found in 5/53 (9.4%) of the cases and in 7/66 (10.6%) controls. The most frequent deficiency was IgG3sd and this was found in three participants in the case group and seven in the control group. The mean level of IgG3 was lower in the control group (p = 0.02). The mean level of IL-8 was lower in the case group (p = 0.02). Conclusion: The results show that physicians working in primary health care cannot solely rely on the frequency of antibiotic-treated RTIs as a warning sign for the detection of common humoral immune deficiencies.

Place, publisher, year, edition, pages
Informa Healthcare, 2015. Vol. 47, no 1, 13-19 p.
Keyword [en]
Clinical warning sign; immunoglobulin deficiency; primary health care; respiratory tract infections
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Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-112726DOI: 10.3109/00365548.2014.956330ISI: 000350052400003PubMedID: 25378084OAI: oai:DiVA.org:liu-112726DiVA: diva2:770234
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2017-12-05

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Dahle, CharlotteNilsdotter-Augustinsson, ÅsaBrudin, LarsBjörkander, Janne

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Dahle, CharlotteNilsdotter-Augustinsson, ÅsaBrudin, LarsBjörkander, Janne
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Clinical Immunology and Transfusion MedicineDivision of Microbiology and Molecular MedicineDepartment of Infectious DiseasesDivision of Cardiovascular Medicine
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Scandinavian Journal of Infectious Diseases
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