Journal
CLINICAL IMMUNOLOGY
Volume 135, Issue 2, Pages 255-263Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.clim.2009.10.003
Keywords
Primary immunodeficiency; Intravenous immunoglobulin; Subcutaneous immunoglobulin; Antibiotic prophylaxis; Best practice; Complementary and alternative medicine hygiene
Categories
Funding
- American Academy of Allergy Asthma and Immunology
- Immune Deficiency Foundation
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There are an expanding number of primary immunodeficiency diseases (PIDDs), each associated with unique diagnostic and therapeutic complexities. Limited data, however, exist supporting specific therapeutic interventions. Thus, a survey of PIDD management was administered to allergists/immunologists in the United States to identify current perspectives and practices. Among 405 respondents, the majority of key management practices identified were consistent with existing data and guidelines, including the provision of immunoglobulin therapy, immunoglobulin dosing and selective avoidance of live viral vaccines. Practices for which there are little specific data or evidence-based guidance were also examined, including evaluation of IgG trough levels for patients receiving immunoglobulin, use of prophylactic antibiotics and recommendations for complementary/alternative medicine. Here, variability applied to PIDD patients was identified. Differences between practitioners clinically focused upon PIDD and general allergists/immunologists were also identified. Thus, a need for expanded clinical research in PIDD to optimize management and potentially improve outcomes was defined. (c) 2009 Elsevier Inc. All rights reserved.
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