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Respiratory tract infections in children are one of the most common causes for medical consultations. When the infections are of recurring nature, they are a major reason for the diagnostics for primary immunodeficiency that is in about 65% of cases underlain by disorders of humoral immunity. This study seeks to retrospectively evaluate the history of recurrent respiratory tract infections in children with humoral disorders and the associations among deficiencies in the immune system components. We evaluated 394 children aged 3 months to 18 years. We found 49.5% (195 cases) of children with IgG deficiencies, all of whom had normal IgE levels. There were 8.4% (33 cases) of IgA deficiency, 7.4% (29 cases) of IgM insufficiency, and 4.1% (16 cases) of CD19+ cells deficiency. The elevated level of CD19+ cells was found in 27.7% (109 out of the 394 children). Immunoglobulin deficiencies often coexisted with a deficiency in another immunoglobulin class above outlined. There was an interdependence between IgA abnormality and IgG, IgG3, and IgG4 abnormalities as well as between IgM abnormality and IgG and IgG1 abnormalities. We conclude that respiratory tract infections in children are often underlain by a convergence of IgG with both IgA and IgM abnormal states. The physiopathological meaning of this convergence for the infection course and resulting functional respiratory changes remains elusive.

BackgroundDeficits in disorders of humoral immunity associated with a deficit of antibodies are the most common primary immunodeficiency. Total IgG and IgG subclasses measurements are used to diagnose, differentiate and control in patients with primary and secondary immunodeficiencies.MethodsThe purpose of the study was to analyze the structure patients group according to difference between total IgG and sum of the IgG subclasses and to determine factors affecting the level of this difference. This study was based on data collected from 670 children referred to the Department of Clinical Immunology and Pediatrics in order to diagnose the immune disorders. For all children the level of the total of immunoglobulins IgG and of the IgG subclasses (IgG1, IgG2, IgG3, IgG4) were determined. The group of children was divided into subgroups according to gender, age (under 6 years of age, 6.5–12 years, and 12–18 years), and IgG abnormality (below the normal range, normal and above the normal range). In the patients group, the total IgG values were on average higher than sum of the IgG subclasses.ResultsStatistical analysis shown the all parameters under study (age, gender and IgG abnormality) influence statistically significant on the discrepancy between the sum of the IgG subclasses and total IgG. Assessment of IgG and IgG subclasses levels is based on different methods what causes the discrepancy between the sum of the IgG subclasses and total IgG.ConclusionsStandardization in that regard is crucial. In addition, we have shown the reliability of the results obtained. Despite the determination in two different laboratories and on different analyzers, as well as the freezing process does not affect the test results.

The human immune system’s response to infection is closely related with the type of pathogen. First, a rapid, metabolically inexpensive and non-specific innate immunity is induced, then a specific acquired immunity is activated. In bacterial infections caused by intracellular pathogens, the main role is played by cellular response. In infections caused by bacterial extracellular pathogens, a crucial role is played by antibodies. The clinical symptoms of bacterial and viral infections very often are similar, which is why diagnosing them based only on medical history and physical examination is insufficient. To identify the etiological factors of infections differentiating media, biochemical tests, molecular methods and serological tests are used. The detection of microorganisms or their genetic material can be performed within a short time after the occurrence of an infection. The detection of antibodies is possible only in the appropriate time called the serological window. In a serological diagnostic of infections there are problems with an appropriate interpretation of obtained results. Cross-reactivity can give false positive results for the diagnosis of Chlamydophila pneumonia infection. The problem with the detection of Borrelia burgdorferi infection can be caused by a simultaneous coinfection with different spirochetes, syphilis, mononucleosis or HIV. In serological diagnostics of bacterial infections, the administration of antibiotics to patients before taking serum samples can be responsible for false negative results. Another reason for such results can be a weak humoral response in infected patients. In viral infections, false positive results can be caused by a coinfection of different viruses, especially from the same family or by bacterial or protozoal coinfections or by autoimmune diseases. False-negative results in viral infections often are caused by the early phase of an infection. To properly recognize an etiological factor of infection it is necessary to use an appropriate method, precision of test and collect samples at the appropriate time.

Inborn errors of immunity (IEI), formerly known as primary immunodeficiency disorders (PIDs), are inherited disorders caused by damaging germline variants in single genes, which result in increased susceptibility to infections and in allergic, autoimmune, autoinflammatory, nonmalignant lymphoproliferative, and neoplastic conditions. Along with well-known warning signs of PID, attention should be paid to signs of immune dysregulation, which seem to be equally important to susceptibility to infection in defining IEI. The modern diagnostics of IEI offer a variety of approaches but with some problems. The aim of this review is to discuss the diagnostic challenges in IEI patients in the context of an immune dysregulation background.

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Today, when animals have become family members, thus bringing a whole spectrum of positive effects on both the mental and physical health of people, the more we must bear in mind the potential hazards arising from such a relationship in order to make possessing companion animals both pleasant and safe. One such threat is undoubtedly dirofilariosis. Dirofilariosis is a parasitic zoonosis caused by the invasion of mosquito-borne nematodes of the genus Dirofilaria. Man is an accidental host of the parasite. Although dirofilariosis is considered to be an endemic disease of Mediterranean and US origin, which rarely affects humans, the increasing number of diagnosed cases in animals in Poland may in the near future result in frequent invasion of the parasite also in humans in our country. Frequent animal movements as well as the presence in Poland of mosquitoes capable, as a result of climate change, of carrying the pathogen seem to confirm this thesis. Clinical displays of human parasite invasion are mostly pulmonary, subcutaneous and ocular forms, as well as some others, which occur less frequently. Appropriate prophylaxis in animals, as well as the complex treatment of existing invasion, provides both animals and humans with security and comfort of life.