Objective

To review the different causes of secondary immunodeficiencies and provide clinicians with an updated overview of potential factors that contribute to immunodeficiency.

Data Sources

Recent published literature obtained through PubMed database searches, including research articles, review articles, and case reports.

Study Selections

PubMed database searches were conducted using the following keywords: immunodeficiency, antibody deficiency, immunosuppressive drugs, genetic syndrome, malignancy, HIV infection, viral infection, secondary immunodeficiency, nutrition, prematurity, aging, protein-losing enteropathy, nephropathy, trauma, space travel, high altitude, and ultraviolet light. Studies published in the last decade and relevant to the pathogenesis, epidemiology, and clinical characteristics of secondary immunodeficiencies were selected and reviewed.

Results

Researchers continue to investigate and report abnormal immune parameters in the different entities collectively known as secondary immunodeficiencies. Immunodeficiency might occur as a consequence of malnutrition, metabolic disorders, use of immunosuppressive medications, chronic infections, malignancies, severe injuries, and exposure to adverse environmental conditions. The neonate and the elderly may have decreased immune responses relative to healthy adults. Each of these conditions may present with different immune defects of variable severity. The acquired immunodeficiency syndrome results from infections by the human immunodeficiency virus, which targets CD4 T cells leading to defective immune responses. Rituximab is a monoclonal antibody that targets CD20 B cells, and its use might result in persistent hypogammaglobulinemia.

Conclusion

Clinicians should consider secondary immunodeficiencies in the differential diagnosis of a patient with recurrent infections and abnormal immunologic evaluation. The use of biological agents for the treatment of inflammatory conditions and malignancies is an increasingly important cause of secondary immunodeficiency.

中文翻译：

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继发性免疫缺陷

客观的

回顾继发性免疫缺陷的不同原因，并为临床医生提供导致免疫缺陷的潜在因素的最新概述。

数据源

通过 PubMed 数据库搜索获得的最近发表的文献，包括研究文章、评论文章和病例报告。

研究选择

使用以下关键词进行 PubMed 数据库搜索：免疫缺陷、抗体缺乏、免疫抑制药物、遗传综合征、恶性肿瘤、HIV 感染、病毒感染、继发性免疫缺陷、营养、早产、衰老、蛋白质丢失性肠病、肾病、创伤、太空旅行、高海拔和紫外线。选择并回顾了过去十年发表的与继发性免疫缺陷的发病机制、流行病学和临床特征相关的研究。

结果

研究人员继续调查和报告不同实体的异常免疫参数，统称为继发性免疫缺陷。免疫缺陷可能是由于营养不良、代谢紊乱、使用免疫抑制药物、慢性感染、恶性肿瘤、严重损伤和暴露于不利环境条件而发生的。与健康成年人相比，新生儿和老年人的免疫反应可能会降低。这些情况中的每一种都可能出现不同严重程度的不同免疫缺陷。获得性免疫缺陷综合征是由人类免疫缺陷病毒感染引起的，该病毒靶向 CD4 T 细胞，导致免疫反应缺陷。利妥昔单抗是一种靶向 CD20 B 细胞的单克隆抗体，其使用可能导致持续性低丙种球蛋白血症。

结论

临床医生在对复发性感染和免疫学评估异常的患者进行鉴别诊断时应考虑继发性免疫缺陷。使用生物制剂治疗炎症和恶性肿瘤是继发性免疫缺陷的一个日益重要的原因。