Immune Deficiency Disorders: Treatment

Reviewed by Kanao Otsu, MD, MPH
Doctors believe people with an immune deficiency can lead active and full lives. The goal is to help you regain or maintain control of your life.

Common goals for people with an immune deficiency include:

  • Participating in work, school, family and social activities
  • Decreasing the number and severity of infections
  • Having few, if any, side effects from medications and other treatments
  • Feeling good about yourself and your treatment program.

 

Your doctor may prescribe medications or other treatments to make you feel better and to protect you from foreign invaders. Medications and treatments must be chosen for your individual needs. They may need to be adjusted when your needs change.

 

Medications and treatments for immune deficiencies include:

  • Antimicrobial therapy to fight and prevent infections
  • Immune globulin replacement therapy
  • Vaccinations
  • Specialized immune globulins
  • Hematopoietic cell transplant
  • Gene therapy
  • Enzyme replacement therapy
  • Biologics.

 

Antimicrobial Therapy

Antimicrobials, such as antibiotics and antifungals, are medications that fight bacterial or fungal infections. They are used when there are bacterial or fungal infections. Often, it is difficult to determine whether a pulmonary or sinus infection is caused by bacteria, as viral infections can present with similar signs and symptoms. In these cases, the doctor may perform additional testing, such as imaging (X-ray, CT scan), or obtain cultures of secretions from the infected area to determine the nature of the infectious agent. Cultures can also provide sensitivities of that particular organism to determine the most effective antimicrobial agent.

Antimicrobial therapy may also be used to prevent infections, and may be added as a routine medication that is taken as prophylaxis.  

 

Replacement Therapy 

People who are unable to produce adequate amounts or functional immunoglobulins or antibodies may benefit from replacement therapy with gamma globulins. There are a number of immunoglobulins; IgG, IgA, IgM and IgE. Antibody replacement with gamma globulin replaces IgG in the blood. This can be given both intravenously (IVIG) or under the skin, called subcutaneously (SCIG.)

Gamma globulin is made of pooled antibodies from the blood of healthy people. Antibodies from at least 1,000 donors in each treatment provide protection against a wide variety of foreign invaders. The blood is carefully tested, and discarded if there is evidence of contagious diseases such as hepatitis or HIV. Talk with your doctor if you have any questions or concerns.

Because supplemental IgG therapy (IVIG or SCIG) does not contain IgA or IgM, their protective functions are not replaced. People with immune deficiencies may continue to have trouble with certain types of infections despite supplemental IgG therapy. However, treatment with supplemental IgG and early treatment of infections help many people with immune deficiencies lead active and full lives.

 

Specific Immune Globulins

Pathogen-specific immune globulins may be used in some immunocompromised people for prophylaxis against potential life-threatening infection from the offending pathogen. Monoclonal antibody treatment against respiratory syncytial virus (RSV) is used to prevent RSV infection in high-risk populations. Specific immune globulins are also used to prevent or treat varicella infections and cytomegalovirus infections. 

 

Other Treatments

Other treatments are available for some types of immune deficiencies. Hematopoietic cell transplantation, thymus transplantation, gene therapy, enzyme replacement and biologic cytokine inhibitors are examples of these other treatments used to treat specific immune deficiency disorders.

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