Secondary immunodeficiency

Description:

Secondary immunodeficiency (VIDS) meet in medical practice rather often. Patients with VIDS, as a rule, address not only immunologists, but also doctors of various medical specialties.

Symptoms of secondary immunodeficiency:

Frequent aggravations of chronic infectious and inflammatory processes of various etiology and localization (frequent acute respiratory viral infections, existence of the mixed latent bacterial and viral infection — a helikobakterioz, Epstein – Barre - a viral, herpes, Cytomegaloviral infection, frequent aggravations of an adenoid disease with heavy growth in a pharynx of pathogenic flora)
Syndrome of chronic fatigue, asthenoneurotic syndrome
Long subfebrile condition
Limfoadenopatiya
Mialgiya, an arthralgia without signs of system inflammatory process (a rhematoid factor, antistreptolysin Oh, S-reactive protein)
Low efficiency of standard therapy at infectious and inflammatory processes.

Immunological indicators at VIDS:

At VIDS there are changes in the main links of immunity: cellular, humoral, phagocytal.

In the general blood test the resistant leukocytosis or the leukopenia raised by SOE often can come to light the relative lymphocytosis is found (generally this instruction on existence of a viral or intracellular infection). The maintenance of populations and subpopulations of lymphocytes can change, phagocytal activity of neutrophils and/or monocytes changes. At most of patients with VIDS products of interferon an alpha (have antiviral effect) and scale are lowered. Also indicators of a humoral link of immunity (A, G and E immunoglobulins) change. Very often the increased levels of spetsificheskikhimmunoglobulin of G and A to bacterial and viral antigens come to light much.

Treatment of secondary immunodeficiency:

The immunotherapy is, as a rule, appointed taking into account the broken link of immunity, existence of bacterial or virus process. So, at changes of the T-cellular link of immunity Imunofan, Taktivin, interferona, etc. use drugs. At bacterial infections — antibacterial therapy renders good clinical effect in combination with Polioksidoniya's use, immunoglobulins, Likopid, Galavita. At viral infections — antiviral drugs (Valtreks, the Acyclovir, Izoprinozin, Panavir) are combined with use of interferon, inductors of interferon, immunoglobulins, Allokina-alfa, glycyrrhizic acid drugs, etc.

Considering that in some cases only the clinical symptomatology without changes in an immunogramma and vice versa can take place, consulting physicians of our Internet drugstore consider that in correction of VIDS it is necessary to focus on new approaches to therapy.

The new direction in immunology – autoimmunity assessment. Feature of complex assessment of an autoimmunity ("the immune card" of the patient can include 12, 16 or 24 indicators) is not only measurement of "the absolute level" of autoantibodies in serum, but also assessment of their contents of "average level" of autoantibodies at the patient.

"Average level" of autoantibodies can be:
normal;
high (polyclonal activation of an autoimmune link of immunity);
low (polyclonal suppression of an autoimmune link).

Note. "Average level" of autoantibodies is defined by the relation of the sum of values of indicators to their number. Further "average level" of autoantibodies at the patient is compared to the normative values received in group of healthy faces. It is revealed that 90% of patients with clinical manifestations of VIDS have disturbances from an autoimmunity. But against the background of the carried-out complex therapy permanent remission of the chronic inflammatory, infectious processes accompanying VIDS is noted.

Treatment of patients with VIDS:

At the first stage diagnosis and treatment of persistent bacterial and viral infections is carried out. According to indications antibacterial therapy taking into account sensitivity to antibiotics is appointed (most often use cephalosporins and ftorkhinolona). Complex treatment joins an immunotherapy. In combination with antibiotics Polioksidoniya's use intramusculary (in a dose of 6 mg/days every other day — 5 injections) or in candles rektalno is effective (1 candle of 6 mg daily — 10 candles on a course of treatment). At preservation of symptoms of a disease repeated courses of antibiotics are conducted. After the termination of a course of antibacterial therapy or at earlier repeated use of antibiotics use of bacteriophages is shown (they are appointed taking into account sensitivity, a course for 10 days monthly within 2–3 months).

At the following stage diagnosis of an intracellular infection (level of G and A immunoglobulins to M. pneumoniae and C. pneumoniae is defined) is carried out, at detection of high antiserum capacities to these pathogens and existence of clinical signs of a disease, for example, of long cough, treatment by drugs from group of macroleads is carried out, in 7 days it is possible to continue a therapy course using drugs of a tetracycline row — doxycycline. At the complicated forms of a course of clamidiosis, mycoplasmosis — ftorkhinolona of 10-14 days.

In the subsequent diagnosis of existence or lack of active virus process is carried out. At identification of signs of active virus process the course of antiviral therapy is appointed. At frequent recuring of a herpesviridae infection Valtreks's course can be appointed, rehabilitation antiviral therapy is carried out further - Glitsiram it is long (within 1–2 months). Along with reception of antiviral drugs purpose of interferon in the form of rectal candles — Viferon is effective (depending on weight of process of 1 000 000 ME or 3 000 000 ME on 1 soup. 2 times a day).

It is necessary to remember that the leukopenia in peripheral blood, and also a depressive syndrome at patients is a contraindication to purpose of high doses of drugs of interferon alpha (Viferon, Genferon, Gerpferon, etc.). At active virus process with care apply interferona, Imunofan, Taktivin, etc.

The second stage of treatment is a normalization of function (and immunity) intestines as it is known that more than 70% of immunocompetent cells are in intestines. For this purpose use an eliminative diet, use of enteroseptik and probiotics. It is important to recover normal functioning of all bodies of digestive tract – correction of dyskinesia of biliary tract, use of gepatoprotektor (Gepatosan, Phosphogliv, Essentiale forte, Geptral, Thistle drugs, etc.).