Protocols of Standard of Care for Adult Patients with Primary Antibody Deficiencies Will Improve Timing of Diagnosis, Survival, and Quality of Life

Abstract

The majority of primary immunodeficiencies (PIDs) are antibody deficiencies (PADs), and not all of them are rare diseases; As an example, Caucasian individuals suffer from selective IgA deficiency at a frequency of 1:500.In addition to infections, symptomatic patients with PAD are more likely to develop neoplastic, autoimmune, and allergic diseases. In the event that PAD is neglected or delayed for more than ten years, complications develop, eventually resulting in death. No studies have been conducted to devise and report detailed ready-to-use protocols for managing PAD to date.This study aimed to propose protocols and guidelines for the adult PAD patients’ standard care. Preparing the protocol, we considered the frequency and type of laboratory tests, imaging, endoscopic examinations, specialist consultations, and standardized recommendations for further care in the place of residence. As a result of the proposed monitoring scheme, patients can be provided with complete care in terms of their underlying conditions and comorbidities, as well as early detection of complications. This protocol will serve as a guide for physicians dealing with these patients and enable comparisons of patient groups across a variety of treatment centers, even far away from each other. A national consultant in the field of clinical immunology verified the protocol mainly developed by Polish experts from reference immunology centres for adults.

Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies

“…The study included an analysis of BMI, use of addictive substances and selected laboratory tests (CBC with smear, creatinine, eGFR, total protein, albumin, ferritin, folic acid, vitamin B12, vitamin D3), which were included in the author’s standard of care protocol for adult patients with PADs [ 7 ]. The study was conducted from June 2021 to October 2022.…”

“…On the other hand, the use of stimulants is a factor that has a negative effect on the abovementioned diseases and should be eliminated. Improvements in these aspects have become possible with the development and implementation of standard of care protocols for adult patients with primary antibody deficiencies (PADs) [ 7 ].…”

Molecular Linkage between Immune System Disorders and Atherosclerosis

“…It is estimated that 70-80% of patients with PID remain undiagnosed and are not included in patient registries. The delay in diagnosis is up to 10 years, resulting in the occurrence of numerous complications, including death [14]. Therefore, current trends in clinical immunology focus on establishing an accurate diagnosis as soon as possible, which determines the length and quality of life.…”