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Flashcards in Immunodeficiency Deck (53)
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what is immunodeficiency?

Absence or failure of the normal function of the
immune system


what results of immunodeficiency?

increased susceptibility to infection


why are dentists expected to treat increasing numbers of immunodeficient patients?

as people with once-fatal diseases continue to
survive them


what are the classification of immunodeficiency?

-specific-involving abnormalities of B and T cells-problem with adaptive immune system
-non-specific - involving abnormalities in complement or phagocytes- problems with innate immune system


Describe primary immunodeficiency .

primary - due to intrinsic defects,often genetic (age-related decline)


Describe secondary immunodeficiency.

Results from extrinsic factors:
-drug therapies for cancer or autoimmune disease
-irradiation (e.g. in cancer treatment)
-organ or bone marrow transplantation protocols
-malnutrition, alcoholism
-certain infections


Describe B cell immunodefiences.

1. Low serum levels (hypogammaglobulinaemia)
2. recurrent pyogenic infections i.e sinusitis - ifutreated, severe obstructive lung disease develops from recurrent pneumonia
3. mostly occur as primary (born with)
4. rare with exception of IgA deficiency
5. Treatment -intravenous replacement therapy with Ig


Name the infectious susceptibility and oral manifestations of No Ig production.

IS-Respiratory infections with extracellular bacteria,
Giardia infection in GI tract
Enterovirus infections
OM-Possible sepsis from abscessed teeth


Name the infectious susceptibility and oral manifestations of severely decreased or No IgG production.

IS-Respiratory infections with extracellular bacteria
Some patients asymptomatic
OM-Possible sepsis from abscessed teeth ,
Some patients asymptomatic


Name the infectious susceptibility and oral manifestations of severely decreased or No IgA production.

IS-Respiratory and GI tract infections
Some patients asymptomatic
OM-Candidiasis ,
Oral ulcerations,
Some patients asymptomatic


what are patients with no T cells or poor T cell function susceptible to?

opportunistic infections e.g herpes


what is T cell immunodeficiencies due to?

-MHC defects
-CD40 ligand deficiency
-CD3 mutations
-Decreased T cell number


since B cell function depends on T cell function , what does T cell immunodeficiencies also result in?

deficiency i.e. combined immunodeficiency


how severe are primary T cell immunodeficiencies?

rare and often fatal e.g severe combined immunodeficiency (SCID)


What are side effects of patients with SCID ?

-Failure to thrive, repeated infections i.e herpes simplex
-During first 6-9 months maternally acquired antibodies offer some
protection. Thereafter bacterial infections much
more common


Name some oral manifestations in SCID.

-Herpes infections
-Recurrent ulcerations of tongue and buccal mucosa
-Severe necrotizing gingivostomatitis


what does AIDS stand for?

Acquired Immunodeficiency Syndrome
Acquired Immune Deficiency Syndrome


how is secondary T cell immunodeficiency caused by?

caused by infection with HIV (human immunodeficiency virus)


how is HIV transmitted?

1. Sexual contact
2. Transfer via placenta or milk from mother
to infant
3. Blood transfusion
4. Needle sharing - intravenous drug use
5. Needlestick injuries


Describe how HIV infiltrates cell.

-HIV interacts with our helper T cells , major receptor of HIV to bind to CD4( found in helper t cells)
-Release of RNA
-Reverse transcibred –double stranded DNA forms -integrated into host DNA
Cell activation –HIV rna is transcibred
Proteins for extrerior part of virus translated and released


Describe clinical stages of AIDS.

-Infection with HIV -
many individuals asymptomatic
some develop transient fever, swollen lymph nodes,
sore throat, rash

-Abs against HIV proteins take 2-6 weeks to develop
Standard HIV infection tests detect these

-After 1o infection, period of latency (no or few
Progression to AIDS takes 2-15 years


when is HIV then classified as AIDS?

Classified as AIDS when CD4+ T cells <200 cells/l


what are the clinical stages of AIDS?

a) Major opportunistic infectionsE.g. Pneumocystis jirovecii pneumonia,Cryptosporidial diarrhoea
b) malignancy e.g. Kaposi’s sarcoma (tumour of endothelial cells)
c) Thrombocytopenia (low platelet count)
d) nervous system disease - dementia and paralysis


how can HIV be treated?

-HIV infection can be controlled with highly active antiretroviral therapy (HAART)


what is HAART a combination of?

nucleoside analog reverse transcription inhibitors
and non-nucleoside RT inhibitor or protease inhibitor


when is HAART recommended?

-when CD4+ T cell count is below 350 cells/l
-in all patients with AIDS defining illness
-when serum HIV RNA is >50,000-100,000 copies/ml


what does HIV/AIDS cause for oral health?

-herpes (fever blisters)
-hairy leukoplakia
-oral candidiasis
-aphthous ulcers
-oral warts
-dry mouth


how rare are defects in complement proteins?

-rare and often inherited


what is complement important in fighting?

infection anf dissolving immune complexes


how do complement defences often present as?

-Recurrent infections or
-Immune complex disease (SLE-like)