Secondary immunodeficiency diseases are not a single independent condition but rather a group of immunodeficiency syndromes caused by various acquired factors. In clinical practice, these conditions are far more common than primary immunodeficiency diseases and should be given due attention.

bubble_chart Etiology

Disease causes

(1) Lesions of immune organs or immune cells: various types of leukemia, thymus diseases, cervical malignancy with cachexia, Hodgkin's disease, and autoimmune diseases, etc. (2) Infectious diseases: severe bacterial, viral, or protozoan infections. (3) Chemical drugs: such as vincristine, cyclophosphamide, 6MP, adrenal corticosteroids, chloramphenicol, tetracycline, rifampicin, aspirin, phenylbutazone, etc., which can cause immune function suppression. (4) Physical factors: X-rays, neutron radiation, radiotherapy such as cobalt-60, etc. (5) Chronic sexually transmitted diseases: diabetes, uremia, nephrotic syndrome. (6) Nutritional disorders: protein malnutrition, deficiencies in iron, zinc, lithium, vitamin B6, C, A, etc. (7) Hemolytic diseases: primary malabsorption syndrome, intestinal malformations, intestinal fistulas, intestinal TB, various chronic enteritis, etc., which affect intestinal digestion and absorption of proteins, leading to protein deficiency. (8) Certain congenital disorders such as trisomy 21, trisomy 18 syndrome, myotonic dystrophy, etc. (9) Premature infants and low birth weight infants. Certain severe traumas, burns, major surgeries under general anesthesia, etc. (11) Post-splenectomy and post-tonsillectomy.

Pathogenesis

On the basis of the aforementioned primary diseases, the immune organs or cells and their functions are affected, leading to their reduction or loss. Most cases are recoverable or temporary. It can affect non-specific immune functions, such as neutrophils and complement, as well as specific immune functions, including cellular immunity and humoral immunity, resulting in reduced functionality. Some cases involve the impairment of one or multiple functions. For example, severe hypoproteinemia can lead to impaired synthesis of various immunoglobulins.

(1) Manifestations of the primary disease are present. (2) Most cases exhibit recurrent infections caused by bacteria, viruses, fungi, or protozoa. (3) Conventional anti-infective treatments show poor efficacy. (4) The prognosis depends on the underlying disease cause and the primary condition.

bubble_chart Treatment Measures

﹝Treatment﹞

(1) Treat the primary disease. (2) Supportive therapy. (3) Prevent and treat various infections. (4) Transfuse blood or plasma, and administer albumin in cases of low plasma protein. (5) Administer immunoglobulin injections. (6) Transfuse leukocytes. (7) Inject transfer factor, interferon, or thymosin. (8) Administer levamisole orally.