Table IV.
Warning signs of PIDD for pulmonologists
| Clinical occurrences | PIDD | Laboratory tests |
|---|---|---|
| Pneumonias due to extracellular bacteria + otitis and sinusitis | Antibody deficiencies | AMI |
| Complement deficiencies | C, ANA | |
|
Pulmonary abscess Pneumatocele |
Hyper IgE syndrome (HIES) Features: pneumonia by S aureus, eczema, fungal infection, joint hypermobility, coarse facial features |
Serum IgE, eosinophilia Specific Scorea |
| Pneumonias due to Staphylococcus or fungi | Chronic granulomatous disease (CGD): susceptibility to infections by catalase positive microorganisms. Other infections: adenitis, liver abscess, osteomyelitis | P |
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency Myeloperoxidase deficiency (common in diabetes) |
G6PD activity Peroxidase level |
|
| HIES |
Serum IgE, eosinophilia Specific Scorea |
|
| Pneumonia due to P jiroveci | T cell deficiencies/CD4+ lymphopenia |
CMI, AMI Lymphoproliferation assay |
| CD40 ligand (L) deficiency | AMI, CMI | |
| Wiskott-Aldrich syndrome (WAS), eczema + thrombocytopenia | CBC including platelet number and size (small sized platelets); CMI, AMI | |
| Pneumonia due to Mycobacteria tuberculosis or atypical mycobacteria | T cell deficiencies/CD40L deficiency | CMI, AMI |
| Mendelian susceptibility to mycobacterial diseases | II |
Abbreviations: AMI antibody mediated immunity, ANA antinuclear antibodies, CBC complete blood count, CMI cellular mediated immunity, II innate immunity, P phagocytosis
aScore for classical Hyper IgE diagnosis [26]