Avoid prescribing routine immunological tests in children with recurrent respiratory infections.
Immunological and genetic investigations are not need when the child is suffering from undifferentiated common viral infections affecting the upper airways and when there is no family history of primary lung diseases or hereditary immunodeficiencies. The decision to perform tests should be based not only on the number of infections, but expecially on their severity, on the presence of unusual or opportunistic germs, on the protracted course and on the occurrence of infections beyond the age of primary socialization. Complete blood cell count and the dosage of immunoglobulins are considered first level tests, together with the sweat test in patients with recurrence of ear infections, bacterial sinusitis, bronchopneumonia or other invasive infections.
1. Notarangelo LD: Primary immunodeficiencies J Allergy Clin Immunol 2010 Feb; 125(Suppl): S182-94. doi: 10.1016/j.jaci.2009.07.053. Epub 2009 Dec 29.
2. Brand PL, Hoving MF, de Groot EP: Evaluating the child with recurrent lower respiratory tract infections. Paediatr Respir Rev 2012 Sep;13(3): 135-8.
3. Bousfiha AA, Jeddane L, Ailal F, et al: A phenotypic approach for IUIS PID classification and diagnosis: guidelines for clinicians at the bedside. J Clin Immunol 2013 Aug; 33(6): 1078-87. doi: 10.1007/s10875-013-9901-6. Epub 2013 May 9.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.