oa Current Allergy & Clinical Immunology - Appropriate investigation for primary immunodeficiency in South Africa : review article

Volume 25, Issue 4
  • ISSN : 1609-3607



Primary immunodeficiencies (PIDs) are rare but patients with recurrent infections are common. Every clinician needs an approach to appropriate laboratory investigation for confirming or excluding PID. Owing to the complexity of the immune system a staged diagnostic approach is utilised. The approach begins with excluding causes of secondary immune deficiency, followed by screening with a full blood count, white cell differential and antibody levels. Second-line tests include complement screens, antibodies to specific antigens and flow cytometry for T- and B-cell numbers. Third-line testing involves tests of cellular function, which are more specialised assays. These assays should be selected based on the presentation and history of the patient. The third-line tests may lead to suggested genetic or molecular testing for confirmation of the diagnosis. Finally, all patients diagnosed with PID should be invited to participate in the South African Primary Immune Deficiency Registry. This will allow strengthening of diagnostic and therapeutic services for PID in South Africa.

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