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Primary Immunodeficiency (PI) and the Immune System

The term "primary immunodeficiency" or "PI" refers to more than 100 congenital diseases that affect the immune systems of both children and adults. According to the Immune Deficiency Foundation (IDF) Web site, www.primaryimmune.org, as many as 1 in every 500 babies will be born with some form of PI.

When part of the immune system is absent or does not function properly due to PI, the body may have difficulty fighting infections. Signs and symptoms leading to the diagnosis of PI may include recurrent or persistent infections, developmental delays as a result of infection, particular organ problems, or development of an autoimmune disease (in which the immune system attacks the patient's own cells or tissues as if they were foreign). The indicators vary depending on the nature of the immune system defect.

Diagnosis can be difficult if symptoms are absent or don't recur frequently. In fact, a recent survey conducted by the IDF indicates that the average time lapse between onset of symptoms and accurate diagnosis of PI is a "staggering" twelve years. A definitive diagnosis may be made by performing a full blood count, testing T-cell and B-cell function, testing phagocyte function, and checking immunoglobulin (Ig) levels.

Treating PI involves supplying the body with infusions of replacement Ig to boost the immune system and help prevent infections throughout the body. These infusions can be administered by intravenous Ig (IVIg) or by subcutaneous Ig (Sub-Q Ig). Vivaglobin® is the only FDA-approved treatment for PI that is administered subcutaneously.

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