Deficiency of various micronutrients is causing secondary immunodeficiency
and predominate the individuals for infections related morbidity.
Mycobacterial, fungal and other opportunistic infections force the clinician to rule out a large list of conditions associated with secondary immunodeficiency
as infectious agents (HIV, Herpesvirus, HTLV), drugs (steroids, immunosuppressants, biologics, chemotherapy), metabolic diseases (diabetes, renal failure, cirrhosis), malignancies (leukemia, lymphomas and solid tumors) and environmental conditions (radiation, heavy metals) (2) but even adult patients can have late onset primary genetic immunodeficiency disorders as chronic granulomatous disease, X-linked agammaglobulinemia, interleukin-12 receptor deficiency or interferongamma (IFN-?
Idiopathic CD4 lymphocytopenia for the first time was described in the year 1992 by the CDC, as cases which demonstrated depressed (<300/cumm) numbers and proportions of CD4 count (<20% of total T cells), on at least two consecutive occasions, with no laboratory evidence of HIV-1 and HIV-2 infection, HTLV-1 or HTLV-2 infection, and the absence of any primary or secondary immunodeficiency
disease, or treatment associated with depressed level of CD4 levels.
To offer the proper diagnosis and treatment of patients presenting with features of primary and secondary immunodeficiency
, I would develop and introduce in Sudan a complement, flow cytometry, or molecular test for primary immune deficiency disease.
The considerable disorders of both cellular and humoral immunity indicating state of secondary immunodeficiency
induced, first of all, by increase in suppressive activity that partially confirmed by parameters CD95+lymphocytes, responsible for apoptosis more changing in the patients with psoriasis, particularly in its severe forms.
Vivaglobin is approved in the European Union and Switzerland for treating PI as well as secondary immunodeficiency
The association of IgG 1 with several primary or secondary immunodeficiency
states, the relation of IgG2 to polysaccharide antibodies and the identification of IgG3 with some autoimmune conditions have all been previously reported, however an isolated IgG4 deficiency has not been convincingly demonstrated (3).