One of the most common problems seen in patients, with or without lung disease, is infections. Most of the infections are viral and have only supportive care as their treatment. The body’s defense against infection is something called our immune system. The immune system is made up of two components. There is a cellular component made up of special cells that are in the blood stream and help to destroy infectious invaders. The second component involves specialized molecules, called immunoglobulins, which also attack infections. Without our immune system we would not survive.
Many of our patients with chronic lung disease have frequent infections, which are the cause for their exacerbations. As we have discussed many times, exacerbations can cause severe consequences for our patients including hospitalizations, intensive care stays and, in the worst case scenario, death.
Problems with the immune system occur in about 1 in every 2,000 births. These birth defects may be severe, or relatively mild and not discovered until the individual is older. The tip-off for the physician is a patient that has frequent infections, some severe and some mild. To diagnose a patient with an immune deficiency first requires what I refer to as an “index of suspicion”. This means that since the problems are rare they may not be thought about for some time.
The diagnosis of immune deficiencies can be as simple as a blood test. Some treatments are available, and sometimes genetic counseling is appropriate in some families.