JOLLES, S., H. CHAPEL and Jiří LITZMAN. When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach. Clinical and Experimental Immunology. Hoboken: Wiley, 2017, vol. 188, No 3, p. 333-341. ISSN 0009-9104. Available from: https://dx.doi.org/10.1111/cei.12915.
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Basic information
Original name When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach
Authors JOLLES, S. (826 United Kingdom of Great Britain and Northern Ireland), H. CHAPEL (826 United Kingdom of Great Britain and Northern Ireland) and Jiří LITZMAN (203 Czech Republic, guarantor, belonging to the institution).
Edition Clinical and Experimental Immunology, Hoboken, Wiley, 2017, 0009-9104.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30102 Immunology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 3.542
RIV identification code RIV/00216224:14110/17:00096772
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1111/cei.12915
UT WoS 000400993000003
Keywords in English cell activation; complement; human
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 18/3/2018 22:18.
Abstract
Primary antibody deficiencies (PAD) constitute the majority of all primary immunodeficiency diseases (PID) and immunoglobulin replacement forms the mainstay of therapy for many patients in this category. Secondary antibody deficiencies (SAD) represent a larger and expanding number of patients resulting from the use of a wide range of immunosuppressive therapies, in particular those targeting B cells, and may also result from renal or gastrointestinal immunoglobulin losses. While there are clear similarities between primary and secondary antibody deficiencies, there are also significant differences. This review describes a practical approach to the clinical, laboratory and radiological assessment of patients with antibody deficiency, focusing on the factors that determine whether or not immunoglobulin replacement should be used. The decision to treat is more straightforward when defined diagnostic criteria for some of the major PADs, such as common variable immunodeficiency disorders (CVID) or X-linked agammaglobulinaemia (XLA), are fulfilled or, indeed, when there is a very low level of immunoglobulin production in association with an increased frequency of severe or recurrent infections in SAD. However, the presentation of many patients is less clear-cut and represents a considerable challenge in terms of the decision whether or not to treat and the best way in which to assess the outcome of therapy. This decision is important, not least to improve individual quality of life and reduce the morbidity and mortality associated with recurrent infections but also to avoid inappropriate exposure to blood products and to ensure that immunoglobulin, a costly and limited resource, is used to maximal benefit.
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