Hospital pediatrics. Secondary immunodeficiency states. Classification (most important)

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Hospital pediatrics. Secondary immunodeficiency states. Classification (most important)

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3. Secondary immunodeficiency states. Classification

Secondary immunodeficiency states are characterized by a violation of humoral and cellular immunity, the synthesis of complement components, the absence or decrease in the activity of cytotoxic lymphocytes and macrophages. In childhood, they lead to the breakdown of post-vaccination immunity and the ineffectiveness of vaccination programs.

Secondary immunodeficiency states - These are disorders of the immune system that develop in the post-neonatal period in children or adults and are not the result of genetic defects. Causes leading to the development of secondary immunodeficiency states: nutritional deficiencies, chronic viral and bacterial infections, chemo- and corticosteroid therapy, irrational use of drugs, age-related atrophy of the thymus, exposure to radiation, unbalanced diet, poor-quality drinking water, extensive surgical operations, excessive physical activity , multiple injuries, stress, exposure to pesticides, other environmental factors.

Classification- Classification of secondary immunodeficiency states 1. Systemic, developing as a result of damage to immunogenesis (with radiation, toxic, infectious and stress lesions).

2. Local, characterized by regional damage to immunocompetent cells (local disorders of the immune apparatus of mucous membranes, skin and other tissues, developed as a result of local inflammatory, atrophic and hypoxic disorders).

Diseases accompanied by secondary immunodeficiency states

1. Infectious diseases: protozoal and helminthic diseases; bacterial, viral and fungal infections.

2. Eating disorders: malnutrition, cachexia, malabsorption syndrome, etc.

3. Exogenous and endogenous intoxications - with renal and hepatic insufficiency, with poisoning, etc.

4. Tumors of lymphoreticular tissue (lympholeukemia, thymoma, granulomatosis and other neoplasms).

5. Metabolic diseases (diabetes mellitus).

6. Protein loss in intestinal diseases, nephrotic syndrome, burn disease, etc.

7. The action of various types of radiation.

8. Strong prolonged stress.

9. The action of drugs.

10. Blockade by immune complexes and antibodies of lymphocytes in allergic and autoimmune diseases.

With the syndrome of violation of anti-infective protection - adequate antibacterial, antiviral, antifungal and antiparasitic therapy; immunomodulatory drugs; rational mode of antigenic loads, including vaccination. Allergy syndrome treatment - dissociation from causally significant allergens, elimination of metabolic products, enzyme replacement therapy, hyposensitizing effects, immunomodulatory measures according to an individual program. In the treatment of diseases associated with the development of an autoimmune syndrome, antibacterial therapy is unpromising; cytostatics, extracorporeal methods of treatment, intravenous administration of immunoglobulin-containing drugs are indicated. In the stage of subsiding the inflammatory process - immunomodulatory therapy and drugs containing cytokines - leukinferon, interferon, reaferon, etc. In all cases, sanitation of foci of chronic infections.

Author: Pavlova N.V.

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