Clinical characteristics of pediatric patients evaluated for primary immunodeficiency

OBJECTIVE: When to evaluate a child for possible immune deficiency is a challenge, as many children have frequent infections for which they are treated with antibiotics. We aimed to describe the clinical characteristics of children evaluated for possible primary immunodeficiency in a specialist clinic. We specifically aimed to evaluate widely promulgated 'warning signs of primary immunodeficiency' and to evaluate the relationship between primary immunodeficiency and atopy. METHODS: A retrospective analysis of 141 children who underwent testing for possible primary immunodeficiency was undertaken. RESULTS: Thirty-two (23%) children were diagnosed with an underlying primary immunodeficiency, and published warning signs were neither sensitive nor specific for primary immunodeficiency. Patients with allergy as determined by the presence of antigen-specific IgE were more likely to be diagnosed with immunodeficiency. CONCLUSIONS: Widely promulgated warning signs did not distinguish between patients with and without primary immunodeficiency. Likewise, primary immunodeficiency and allergy may coexist.