Humoral Immune Deficiency

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2021-01-18
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Humoral immune deficiencies are conditions which cause impairment of humoral immunity, which can lead to immunodeficiency. It can be mediated by insufficient number or function of B cells, the plasma cells they differentiate into, or the antibody secreted by the plasma cells. The most common such immunodeficiency is inherited selective IgA deficiency, occurring between 1 in 100 and 1 in 1000 persons, depending on population. They are associated with increased vulnerability to infection, but can be difficult to detect (or asymptomatic) in the absence of infection.

Signs and symptoms

Signs/symptoms of humoral immune deficiency depend on the cause, but generally include signs of infection such as:

  • Sinusitis
  • Sepsis
  • Skin infection
  • Pneumonia

Causes

Cause of this deficiency is divided into primary and secondary:

  • Primary the International Union of Immunological Societies classifies primary immune deficiencies of the humoral system as follows:
Hyper-IgM syndromes(immunoglobulin M)
  • Absent B cells with a resultant severe reduction of all types of antibody: X-linked agammaglobulinemia (btk deficiency, or Bruton's agammaglobulinemia), μ-Heavy chain deficiency, l 5 deficiency, Igα deficiency, BLNK deficiency, thymoma with immunodeficiency
  • B cells low but present, but with reduction in 2 or more isotypes (usually IgG & IgA, sometimes IgM): common variable immunodeficiency (CVID), ICOS deficiency, CD19 deficiency, TACI (TNFRSF13B) deficiency, BAFF receptor deficiency.
  • Normal numbers of B cells with decreased IgG and IgA and increased IgM: Hyper-IgM syndromes
  • Normal numbers of B cells with isotype or light chain deficiencies: heavy chain deletions, kappa chain deficiency, isolated IgG subclass deficiency, IgA with IgG subsclass deficiency, selective immunoglobulin A deficiency
  • Transient hypogammaglobulinemia of infancy (THI)
  • Secondary secondary (or acquired) forms of humoral immune deficiency are mainly due to hematopoietic malignancies and infections that disrupt the immune system:
  • Multiple myeloma
  • Chronic lymphoid leukemia
  • AIDS

Diagnosis

Human B cell

In terms of diagnosis of humoral immune deficiency depends upon the following:

  • Measure serum immunoglobulin levels
  • B cell count
  • Family medical history

Treatment

Treatment for B cell deficiency (humoral immune deficiency) depends on the cause, however generally the following applies:

  • Treatment of infection (antibiotics)
  • Surveillance for malignancies
  • Immunoglobulin replacement therapy

See also

  • Immunodeficiency
  • T cell deficiency