Immunodeficiency, primary

• 279.06 Common variable immunodeficiency
• 279.2 Combined immunity deficiency

• 315.4 Developmental coordination disorder
• 718.45 Contracture of joint, pelvic region, and thigh
• 719.70 Difficulty in walking involving joint site unspecified
• 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
• 728.89 Other disorders of muscle, ligament, and fascia
• 729.9 Other and unspecified disorders of soft tissue
• 780.7 Malaise and fatigue
• 781.2 Abnormality of gait
• 782.3 Edema
• 786.0 Dyspnea and respiratory abnormalities
• 786.05 Shortness of breath

• D83.8 Other common variable immunodeficiencies
• D83.9 Common variable immunodeficiency, unspecified
• D81.0 Severe combined immunodeficiency (SCID) with reticular dysgenesis
• D81.1 Severe combined immunodeficiency (SCID) with low T- and B-cell numbers
• D81.2 Severe combined immunodeficiency (SCID) with low or normal B-cell numbers
• D81.89 Other combined immunodeficiencies
• D81.9 Combined immunodeficiency, unspecified

• Note: the APTA Guide to Physical Therapist Practice includes practice patterns for neuromuscular and musculoskeletal systems; as primary immunodeficiency is medical in nature, the practice patterns addressed are those for associated disorders that may occur and impair aerobic capacity
• 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction
• 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation
• 6B: Impaired aerobic capacity/endurance associated with deconditioning
• 7B: Impaired integumentary integrity secondary to superficial skin involvement

Description

• Failure of the body to provide defense against bacterial or viral invasion as there is no or insufficient production of antibodies
• There are 70 to 100 types in approximately six categories
• Primary immunodeficiency disorders
• Congenital immunodeficiency diseases
• B-cell (antibody) deficiencies
• T-cell deficiencies
• Combination B- and T-cell deficiencies
• Defective phagocytes
• Complement deficiencies
• Unknown (idiopathic)
• Severe combined immunodeficiency (SCID) (bubble boy disease) is considered the most severe form of the disease
  • Chronic infections
  • Frequent infections
  • Multiple body-system involvement
  • Onset often vague with misdiagnosis of underlying disease

Essentials of Diagnosis

• Must be made by a physician and confirmed by medical diagnostic testing
• Warning signs of primary immunodeficiency
  • Eight or more new ear infections within one year
  • Two or more serious sinus infections within one year
  • Two or more months on antibiotics with little effect
  • Two or more pneumonias within one year
  • Failure of an infant to gain weight or grow normally
  • Recurrent, deep skin or organ abscesses
  • Persistent thrush in mouth or elsewhere on skin, after age one
  • Need for intravenous antibiotics to clear infections
  • Two or more deep-seated infections such as sepsis, meningitis, or cellulitis
  • A family history of primary immune deficiency
• Frequent/recurrent Infections
• Blood infections
• Inflammation of internal organs: liver, spleen, pancreas
• Autoimmune disorders
• Blood disorders
• Digestive problems
• Delayed growth and development
• Genetic factors
• Abscessed wounds
• Ineffective use of antibiotics

General Considerations

• May result in secondary problems such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight loss indicating the need for PT intervention depending on severity
• Once thought ...