Immunosuppression in Patients With Primary Immunodeficiency-Walking the Line

Department

Allergy and Immunology

Document Type

Article

Publication Title

The Journal of Allergy and Clinical Immunology. In practice

Abstract

Individuals with primary immunodeficiency (PIDD) experience not only infectious complications but also immune dysregulation leading to autoimmunity, inflammation, and lymphoproliferative manifestations. Management of these complications often requires treatment with additional immunosuppressive medications, which pose an additional risk of infectious complications. Immunosuppression in individuals with PIDD therefore requires careful assessment and consideration of risks and benefits. Medications should be closely monitored, and strategies for risk mitigation of adverse events considered, such as exposure reduction, appropriate vaccination, use of antibiotics/antivirals, and optimization of immunoglobulin replacement therapy. In a subset of individuals who are not tolerating immune modulation or experiencing disease progression despite appropriate interventions, hematopoietic stem-cell transplantation is a management option.

First Page

3088

Last Page

3096

DOI

10.1016/j.jaip.2022.08.025

Volume

10

Issue

12

Publication Date

12-1-2022

Medical Subject Headings

Humans; Immunosuppression Therapy; Hematopoietic Stem Cell Transplantation (adverse effects); Vaccination

PubMed ID

36049628

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