Primary immunodeficiency - analysis of registry of Institute of Immnunology

The emergence of highly effective therapy has led to an increase in the life expectancy of patients with primary immunodeficiency (PID). Currently, we have the opportunity to observe the first generation of adults suffering from PID. Objective. To study the structure of the PID forms in Russian adults of the register of Institute of immunology of FMBA Russia. Materials and methods. The analysis of PID structure, demographic data and need for therapy was carried out on the basis of472 patient’s case histories who were treated in the Institute of immunology from 1983 to 2017. Results. The main part of patients older than 18 years (472 people) of Russian PID population are presented with predominant antibody deficiency - 61,22% and hereditary angioedema (HAE) - 30,72%, other PID forms are presented by isolated clinical cases. In 21,82% of cases, the disease debuted at the age of 18 years, with the diagnosis of PID was established after 18 years in 62,4% of cases (294 patients out of472). The average age of adult registry of PID patients is 39,6±6 years, median age - 35,6 years, maximum age - 86 years. Persistent disability is observed in 12,5% of cases. A study of the availability and adequacy of therapy showed that replacement therapy with immunoglobulins (IVIG) in need by 53,7%, but only 27,4% have it on the regularly and conditionally adequate dose, for 5,7% IVIG therapy is unavailable, while the majority of patients - 66,8% receive IVIG irregular and/or in inadequate dose. The presence of splenomegaly, hepatomegaly and enteropathy significantly lengthen the diagnosis period (p<0,05). B-cell phenotyping showed that this method is a specific and reproducible test for the diagnosis of common variable immunodeficiency (CVID), allows to minimize the number of diagnostic errors and reduce the time of diagnosis. The search for reliable immunological markers-predictors of complications of CVID did not give results.

primary immunodeficiency, adults, antibody deficiency, immunoglobulins