Immunology and Allergy is the specialisation that focuses on treating conditions caused by various abnormalities of the immune system. On one hand, over activity of the various parts of the immune system leads to allergy and auto immunity. In these situations, a range of illnesses varying from mild hayfever to life threatening allergic reactions result from an improperly regulated immune response.

An allergist / immunologist (commonly referred to as an allergist) is a physician specially trained to diagnose, treat and manage allergies, asthma and immunologic disorders including primary immunodeficiency disorders. These conditions range from the very common to the very rare, spanning all ages and encompassing various organ systems.

Immunodeficiency Arises

When part of the immune system is either absent or not functioning properly. When the cause of this deficiency is hereditary or genetic, it is called a primary immunodeficiency disease (PIDD). There are more than 150 different kinds of disorders known as PIDD. The immune system is composed of white blood cells. These cells are made in the bone marrow and travel through the bloodstream and lymph nodes. They protect and defend against attacks by “foreign” invaders such as fungi, bacteria and viruses.

In the most common PIDDs, different forms of these cells are missing. This creates a pattern of repeated infections, severe infections and/or infections that are unusually hard to cure. These infections may attack the skin, respiratory system, the ears, the brain or spinal cord, or the urinary and gastrointestinal tracts. In some instances, PIDD are associated with disorders in other organ systems. For example, heart defects are present in some PIDDs. Other PIDDs alter facial features, some stunt normal growth and still others are connected to autoimmune disorders such as rheumatoid arthritis and systemic lupus erythemetosis.

Primary Immunodeficiency Disease Symptoms & Diagnosis

Most serious PIDDs become apparent in infancy. In milder forms, it often takes a pattern of recurrent infections before PIDD is suspected. In some cases, a PIDD is not diagnosed until individuals reach their 20s and 30s.
Important signs that may indicate a PIDD include:

    • Recurrent, unusual or difficult to treat infections
    • Poor growth or loss of weight
    • Recurrent pneumonia, ear infections or sinusitis
    • Multiple courses of antibiotics or IV antibiotics necessary to clear infections
    • Recurrent deep abscesses of the organs or skin
    • A family history of PIDD
    • Swollen lymph glands or an enlarged spleen
    • Auto-immune disease

Some immunodeficiency disorders are not primary (hereditary or genetic). A secondary immune deficiency disease occurs when the immune system is compromised due to an environmental factor. Examples of these external causes include HIV, chemotherapy, severe burns or malnutrition.

Dr. Michael Loubser
Paediatrics, Immunology, Asthma & Allergy