Repositorio
Institucional

Edgar, John David M.

Richter, Alex G.#Huissoon, Aarnoud P.#Kumararatne, Dinakantha S.#Baxendale, Helen E.#Bethune, Claire A.#Garcez, Tomaz#Misbah, Siraj A.#Sorensen, Ricardo U.

Prescribing Immunoglobulin Replacement Therapy for Patients with Non-classical and Secondary Antibody Deficiency: an Analysis of the Practice of Clinical Immunologists in the UK and Republic of Ireland

SPRINGER/PLENUM PUBLISHERS

JOURNAL OF CLINICAL IMMUNOLOGY

en

Immunologists are increasingly being asked to assess patients with non-classical and secondary antibody deficiency to determine their potential need for immunoglobulin replacement therapy (IGRT). Immunoglobulin is a limited, expensive resource and no clear guidance exists for this broad patient group. The purpose of this survey is to establish what factors influence the decision to commence IGRT in adult patients, when diagnostic criteria for primary antibody deficiency are not fulfilled. Under the auspices of the United Kingdom Primary Immunodeficiency Network (UKPIN), a study group was established which circulated an online questionnaire to the consultant body across the UK and Ireland. Results provided a snapshot of the current clinical practice of 71% of consultant immunologists, from 30 centers. In order of importance, factors which influence the decision to commence IGRT include number of hospital admissions with infection, serum IgG level, bronchiectasis, radiologically proven pneumonia, number of positive sputum cultures, number of antibiotic courses, and results of immunization studies. The commonest test vaccine used was Pneumovax 23 with measurement of serotype-specific responses at 4 weeks, with a threshold of 0.35 mu g/ml in 2/3 of serotypes measured. Eighty-six percent of patients are treated with a trial of prophylactic antibiotics prior to consideration of IGRT. Efficacy of IGRT trial is assessed at between 6 and 12 months. There was consistency in clinical practice using a combination of clinical history, evidence of infections, and vaccination testing for diagnosis. However, there was some variation in the implementation of this practice, particularly in vaccine choice and assessment of response to vaccination.

Artículo original

10.1007/s10875-017-0469-4

pdf

Immunoglobulin replacement# immunodeficiency# diagnosis# therapy# vaccine responses

http://dx.doi.org/10.1007/s10875-017-0469-4

Immunology

Reemplazo de inmunoglobulinas# inmunodeficiencia# diagnóstico# terapia# respuestas a las vacunas

Inmunología

Otros Temas de Medicina Clínica

Servicios y Cuidados en Ciencias de la Salud

WOS:000426893700010

Prescribing Immunoglobulin Replacement Therapy for Patients with Non-classical and Secondary Antibody Deficiency: an Analysis of the Practice of Clinical Immunologists in the UK and Republic of Ireland

Artículo original

version publicada

SPRINGER/PLENUM PUBLISHERS

JOURNAL OF CLINICAL IMMUNOLOGY

Inmunología

0271-9142

en

pdf

hibrida#verde

acceso abierto

acceso abierto

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