Immunodeficiency, primary immunodeficiency, secondary immunodeficiency

Until adulthood, there were no unusual health disorders, maybe he had to suffer from colds a little more often – not once, like most, but twice a year, said Laurynas Ramanauskas, board member of the Lithuanian Primary Immunodeficiency Society “Imunas”.

“It all started when I entered the university – bronchitis and pneumonia kept recurring, I got sick just because another student sneezed in the corridor,” he recalled.

Before determining the real cause of his unwellness, the doctors to whom the then-student turned even suspected that he was faking it. After a week, two or even three antibiotics, the illness did not go away, what’s more, for about two years, I continued to feel bad, and the lack of energy was especially bothersome – I would run out of energy after half a day.

“After those two years, by a happy coincidence, I was referred to immunologists. They did tests and it turned out that I just don’t have the immunity of a certain group, that’s why it happened again [susirgimai].”

Now diseases are in the past, because L. Ramanauskas takes medicine and even if he gets a cold, he recovers quickly, like most people. After two years of recurring illnesses, the immunologist doctors prescribed treatment – one day a month it was necessary to stay in the hospital and through it they administered intravenous drugs, which, of course, had side effects. Anyway, after the medication, the man said that he lived a full life – the diseases did not come on so quickly.

As a member of the board of the “Imunas” society told at the press conference, 10 years ago, a new drug appeared, which a person with immunodeficiency can inject himself into the abdomen once a week, there is no longer a need to go to the hospital.

“Immunodeficiency can be acquired or congenital. Acquired immunodeficiency, also called secondary, occurs when a person either gets a disease that damages the immune system, such as the HIV virus, or uses drugs that damage the immune system, said an allergist at the Pulmonology and Allergology Center of Santaras Clinics of Vilnius University Hospital. -clinical immunologist Professor Laura Malinauskienė. – And primary, or congenital, immunodeficiencies develop when a person is born with a certain immune system defect. And that cannot be changed or avoided.”

According to Professor L. Malinauskienė, “it is important to detect immunodeficiency as early as possible and try to make the patient less likely to get sick or experience complications of diseases”, in general, it would make sense to test all newborns in Lithuania for immunodeficiency, especially since in Western European countries children are given the necessary early after such tests help prevents deaths in this way – because a large number of children with severe combined immunodeficiency do not even reach the age of one year without treatment. And after a bone marrow transplant, such children recover.

All children born in Lithuania are currently examined for dozens of diseases. “The system is already working, it is only necessary to strengthen the procedure for providing assistance to children with immunodeficiency. This requires investment,” said the professor.

With immunofecitis, common pathogens can appear – as in the case of L. Ramanauskas, there are frequent infections, but, according to the professor, other types of malignant, some blood diseases can also occur. “It can also be diseases related to the immune system and its incorrect reaction to itself, that is, the immune system begins to damage the body itself due to the tension that it cannot react correctly,” explained the professor. According to her, because the clinic is so diverse, it is not so easy to recognize, it takes several years, all over the world [imunodeficitas] is not diagnosed immediately <...> at the time when a person is sick, it is not so easy to find and recognize”, so the role of the family doctor is very important – he sees all the diseases of a person and the history of his recovery.

Currently, there are about 300 patients with primary immunodeficiency in Lithuania.

“We don’t know all the sick people,” said the head of the Primary Immunodeficiency Center of Kaunas Clinics of the Lithuanian University of Health Sciences, doctor allergist-clinical immunologist Assoc. Dr. Edita Gasiūnienė. – In Lithuania, primary immunodeficiencies are more often diagnosed in adults.” Unfortunately, untreated diseases can cause complications, and then life is much more difficult for such people.

According to L. Ramanauskas, those with immunodeficiency should join the community. The Primary Immunodeficiency Society “Imunas” already operates in Lithuania. Its members can support the sick, help find specialists, get knowledge, consult, and share experience.

“Many people hide their illness. I rarely talk about her myself. It is very difficult to talk because the public often thinks that it is related to HIV. By joining the society, together we can change society’s attitudes about the disease and only together can we speed up the arrival of innovations – new treatment options to Lithuania”, said the man.

Everyone who is diagnosed with immunodeficiency and those who think they might have this disease, as well as their guardians and relatives, are invited to join. More information about the association’s activities and the disease can be found on the website immunodeficitas.lt. This society, according to its representative, intends to make efforts so that family doctors learn more about immunodeficiencies. “It would be very good if family doctors knew how to recognize immunodeficiency and could send patients to specialists – this would shorten the patients’ path to treatment,” L. Ramanauskas is convinced.

As announced on the website of the Santaras Clinics of the Vilnius University Hospital, “after counting together all known cases of primary immunodeficiency, there are currently about 6,000,000 people suffering from it in the world, more than 638,000 in Europe.

“Secondary immunodeficiencies develop when using immunosuppressive treatment after organ transplantation or autoimmune diseases, chemotherapy, biological therapy. After such treatment, the immune system is often damaged and secondary immunodeficiency develops. In some cases, immunoglobulin replacement therapy is required to correct secondary immunodeficiency.”