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Immunodeficiencies are the weakened condition of immune system of the person which as a result leads to more frequent diseases of infectious illnesses. At an immunodeficiency of an infection proceeds more hard, than at people in a usual state. Such illness at people with an immunodeficiency gives in to therapy also heavier.
According to an origin immunodeficiencies subdivide on primary (that is hereditary) and secondary (that is acquired).
The main signs of an immunodeficiency of both types are chronic infectious diseases. At such states there is a defeat by infections upper and lower respiratory tracts, skin, ENT organs, etc. Display of diseases, their weight and versions are defined depending on what type of an immunodeficiency takes place at the person. Sometimes owing to an immunodeficiency at the person allergic reactions and autoimmune diseases develop.
Primary immunodeficience is the illness of immune system having hereditary character. According to medical statistics, similar defect is shown at one child on ten thousand. Primary immunodeficience – an illness which is transmitted to children from parents. There are many forms of this state. The part of them can be shown openly practically right after the child's birth, other forms of an immunodeficiency have not an effect many years. Approximately in 80% of cases by the time of diagnosis of primary immunodeficience the age of the patient does not exceed twenty years. About 70% of cases of primary immunodeficience are diagnosed for males as the majority of syndromes is directly connected with X-chromosome.
At primary immunodeficience genetic defects, subdivide into several groups. At humoral immunodeficiencies in an organism the sufficient producing antibodies or immunoglobulins is not made; at cellular immune deficiencies the lymphocytic immunodeficiency takes place; at defects of phagocytosis of a bacterium cannot fully be taken leukocytes; at defects of system of a complement inferiority of proteins which destroy alien cells is observed. Besides, combined immunodeficiences, and also some other immunodeficiencies at which there are problems with the main links of immunity are allocated.
In most cases primary immunodeficiences are states which remain at the person throughout all his life. However there are a lot of patients for whom the illness was diagnosed in time, and its adequate treatment was provided, have normal longevity.
It is necessary to understand existence of the acquired diseases of immune system as secondary immunodeficience. In this case, as well as at primary immunodeficiences, it is about too frequent attacks of infectious diseases in connection with the weakened immunity. The most known example of this type of an immunodeficiency is AIDS which develops as a result of HIV infection. Besides, secondary immunodeficiences are shown under the influence of medicines, radiation, certain chronic diseases. Secondary immunodeficience can be observed at patients who see a doctor with complaints to the most different illnesses.
In general, all actions which, anyway, cause weakening of immune system of the person promote development in it of secondary immunodeficience.
Besides, this state arises at food deficits at which proteinaceous and caloric insufficiency, and also a lack of vitamins and microelements is observed. In this case deficit of vitamin A, selenium, zinc especially harmful affects a condition of the person. Also the risk group of immunodeficiencies includes the people having the chronic metabolic frustration arising owing to diseases of a liver and kidneys. Also the people who underwent a serious operation or an injury are somewhat subject to development of an immunodeficiency.
At secondary immunodeficiences it is important as it is possible to find bacterial infections as soon as possible and to undertake necessary treatment.
As the immunodeficiency is shown
The main thing and in certain cases the only sign of immunodeficiencies is predisposition of the person to very frequent display of infectious diseases. Display of recurrent respiratory infections is characteristic of a condition of an immunodeficiency. However in this case doctors accurately differentiate manifestations of an immunodeficiency and so-called morbidity of children who often catch cold from peers.
More characteristic sign of an immunodeficiency is display of a heavy bacterial infection which has recurrent character. As a rule, at its development periodically there is a repetition of pharyngalgias, and also infection of upper respiratory tracts. As a result at the patient chronic sinusitis, bronchitis, otitis develops. Also characteristic of an immunodeficiency is ease of development and the subsequent progressing of diseases. So, at patients with an immunodeficiency bronchitis very easily passes into pneumonia, respiratory insufficiency and a bronchietasia is shown.
Besides, at such patients it is very often shown infections of integuments, mucous membranes of an organism. So, ulcers in a mouth, a periodontal disease, the milkwoman who has resistance to treatment happen the most characteristic states in this case. Besides, at patients with an immunodeficiency very often on a body warts and papillomas develop, eczema and baldness takes place.
A number of frustration of the alimentary system, for example, diarrhea, malabsorption can also be typical manifestation of this state.
In more exceptional cases at an immunodeficiency hematologic disturbances, for example, a leukopenia, autoimmune hemolitic anemia, etc. are diagnosed.
In certain cases also attacks of neurologic character can be observed: spasms, encephalitis, arthritis, vasculitis. There are data on the increased frequency of development of a carcinoma of the stomach in such patients.
Diagnosis of an immunodeficiency
In the course of diagnosis of an immunodeficiency the doctor surely pays close attention to the family anamnesis. So, it is quite possible that in a family frequent autoimmune diseases, early mortality, early display of malignant diseases take place. Also on the similar diagnosis side reaction can indicate vaccination. Carrying out radiation therapy of some areas of a body can also be premises to establishment of the similar diagnosis.
Examining the patient, the attending physician surely pays attention and to its outward. As a rule, such person looks especially painful, he has very pale skin, he constantly suffers from a febricula. Fixed survey of skin as at an immunodeficiency the pyoderma, vesicular rash, eczema is often shown is important.
Besides, other manifestations also are characteristic of a condition of an immunodeficiency: emergence of an inflammation of eyes, chronic diseases of ENT organs, hypostases of nostrils, chronic long cough.
For establishment of the exact analysis it is necessary to conduct careful examination of the patient. At the first stage of researches the developed blood test, screening tests, determination of level of immunoglobulins is, as a rule, appointed. Also other researches which allow to define what type of an infection takes place at the person are appointed. If at the patient the recurrent infection is defined, then inspections of such patient are performed regularly. If necessary, depending on a clinical situation, capture of smears and the subsequent microbiological researches is carried out.
Complications of immunodeficiencies
As often shown complications of both types of immunodeficiencies it should be noted serious infectious diseases, first of all. It is sepsis, pneumonia, abscess, etc. In each case of manifestation of immunodeficiencies of complication are defined individually.
Human immunodeficiency virus
The human immunodeficiency virus can be carried to family of retroviruses. Today physicians define two types of this virus — VICh1 and VICh2. Their basic distinctions consist in antigenic and structural features.
The human immunodeficiency virus is not steady against influence of features of external environment. It is destroyed practically by each substance with disinfecting properties. It is considered that this virus can be in each biological liquid of a human body. But in the absence of blood in such liquid of quantity of a virus insufficiently in order that there was an infection. Therefore, saliva, sweat, tears, emetic weight is considered harmless biological liquids. At the same time in each liquid which is connected with a lymph contains a virus in large numbers. For this reason the risk of transfer of HIV at sexual contacts is very high, and also in the course of feeding of the child a breast. Therefore, the most dangerous liquids of an organism from the point of view of infection of HIV are blood, vaginal secrets, a lymph, sperm, cerebrospinal, ascitic, pericardiac liquids, breast milk.
Human immunodeficiency virus, appearing in an organism, gets to target cells which are regulators in the course of an immune response. Gradually the virus gets to other cells, and pathological process happens in different systems and bodies.
In the course of death of cells of immune system the immunodeficiency which symptoms are caused by a virus is shown. Under its action at the person the diseases having both infectious, and noninfectious character develop.
Weight of an illness and speed of its progressing directly depends on existence of infections, genetic features of a human body, its age, etc. The incubation interval to last from three weeks to three months.
After that there comes the stage of primary manifestations at which at the patient various clinical symptoms are shown and antibodies are actively produced. This stage at different people can proceed differently. Its asymptomatic course, existence of an acute infection without secondary diseases, and also an infection with secondary diseases is possible.
In the course of transition of a virus to a subclinical stage the immunodeficiency gradually accrues, lymph nodes at the person increase, at the same time the speed of reproduction of HIV is slowed down. This stage rather long: it sometimes lasts till twenty years though its average duration makes about six years. Later at the patient acquired immunodeficiency syndrome develops.
Acquired immunodeficiency syndrome
For the first time the world learned about acquired immunodeficiency syndrome in the mid-eighties the twentieth century. At that time physicians found an unknown illness of which manifestation of an immunodeficiency at adults was characteristic. It was established that immune deficit at them was shown in adult years. Therefore, this illness then began to call a syndrome of the acquired immune deficit, in abbreviated form AIDS. For segodnyanshy day AIDS extended to epidemic level.
At development in sick acquired immunodeficiency syndrome its organism cannot resist to attacks even of rather harmless microorganisms.
Diagnosis of HIV infection is made by means of special laboratory methods of researches. However medicines which effectively influence the AIDS virus do not exist today.
Treatment is generally directed to overcoming of the consecutive infections developing owing to an immunodeficiency.
Treatment of immunodeficiencies
The most important point for people for whom the immunodeficiency of any type is diagnosed is the maximum following to the principles of a healthy lifestyle and avoidance of infections. It is regularly not less important to pass surveys at the stomatologist.
With an immunodeficiency it is important to patient to diagnose fungal and bacterial infections in time and to carry out their subsequent adequate therapy.
There are states at which continuous preventive treatment by antibiotics is necessary. If at the person thorax infections take place, then in this case treatment by means of physical therapy, and also regular performance of special physical exercises is reasonable. Sometimes as prophylactics administration of drugs with antiviral influence, for example an amantadina, Rimantadinum is necessary.
In most cases therapy at an immunodeficiency is carried out by means of intravenous or hypodermic administration of immunoglobulins. However it is necessary to consider that the patient with heart failure treatment by immunoglobulin contraindicated. Today also other types of treatment of an immunodeficiency practice, however some of them still stay at a stage of experimental developments.
In the course of treatment of primary immunodeficience it is important to define in each case, use of liquid vaccines is how justified. In all cases it is important to patients for whom primary immunodeficience was diagnosed not to take alcohol, not to smoke.
Immunocorrection is made by means of several methods today. It is transplantation of marrow, use of immunomodulators, immunoglobulins.
At treatment of secondary immunodeficience the general principles of the help are used. It is vaccination, fight against an infection, carrying out replacement therapy.
Prevention of immunodeficiencies
To prevent manifestation of primary immunodeficiences, it is necessary to define probable carriers of defective genes in families which have the positive anamnesis. At certain pathologies carrying out prenatal diagnosis is possible.
In view of hereditary nature of primary immunodeficiences there are no prevention measures for this type of diseases today.
As preventive measures for the prevention of secondary immunodeficiences it is important to avoid infection with HIV infection. It is never for this purpose very important to allow the unprotected sexual contacts, to be convinced that the used medical tools are sterile, etc. The risk group of infection of HIV also includes addicts who even at single injection administration of drug risk to catch a virus.