Immune deficiency

What is immune deficiency?

  • A condition in which your body’s immune system – a network of cells, tissues and organs that work to defend against bacteria, viruses and allergens – is compromised
  • May be responsible for recurrent infections, especially those that are unresponsive to standard treatment
  • May mimic symptoms of allergic reactions, asthma and eczema and mask true cause of recurrent upper and lower respiratory tract infections that are common in children and adults with allergic rhinitis or asthma

Signs and Symptoms

  • Eight or more new ear infections within one year.
  • Two or more serious sinus infections within one year
  • Two or more months of antibiotics resulting in marginal improvement
  • Two or more bouts of pneumonia within one year
  • Recurrent, deep skin or organ abscesses
  • Failure of an infant to gain weight or grow normally
  • Persistent thrush in mouth or elsewhere on skin after age one
  • Need for intravenous (IV) antibiotics to clear infections
  • Two or more serious infections such as meningitis (infection of brain and spinal cord membranes), osteomyelitis (bone infection), cellulitis (skin infection) or sepsis (blood infection)
  • Family history of primary immune deficiency
  • Rapid recurrence of an infection despite completing antibiotic treatments
  • Infection that occurs at an unusual age, unexpected site or part of the body, or fails to respond to normal treatment

Diagnosis and Evaluation

When infections are recurrent or severe, allergists consider immunodeficiency assessment. Because they are trained in the study of the immune system, they can care for patients with immune deficiencies as well as those with allergies and asthma.

  • Allergist performs thorough medical history, environmental history and physical examination and possibly orders lab tests to evaluate levels of immune components in blood
  • May also conduct allergy skin testing appropriate (Read more about Allergy Skin Testing)

Primary Immune Deficiency (PID)

  • Occurs in those born with an immune system lacking ability to fight infections normally
  • More than 150 PID diseases exist – some common, some very rare
  • Caused by genetic or hereditary defects
  • Can affect anyone regardless of age or sex
  • About 400 children born with PID annually
  • About 250,000 children and adults live with PID


  • Primary treatment goals are to minimize symptoms so patients can go about their daily lives and to prevent damage to ears, sinuses and lungs that might result in hearing loss, chronic lung disease, chronic sinusitis or injury to other organ systems.
  • Prophylactic (preventative) antibiotics may be recommended during viral season for patients especially susceptible to ear, sinus and lung infections.
  • Patients unable to produce adequate amounts of immunoglobulins (antibodies) may benefit from immunoglobulin replacement therapy, which replaces what the body should be making but doesn’t help the immune system make more.