International Medical Journal, Vol. 21., Iss. 4, 2015, P. 17−19.
THE ROLE OF CYTOKINE IN DIFFERENTIAL DIAGNOSIS AND TREATMENT OPTIMIZATION AT COMMUNITY ACQUIRED PNEUMONIA IN PATIENTS WITH DIABETES MELLITUS
Kharkiv National Medical University, Ukraine
Dysfunction of immune system or its any link leads to formation of immunodeficiency disease, primary (congenital) or secondary (acquired), with development of immune system decompensation hereafter. In accordance with the WHO nomenclature genetically determined organism inability to realize any link of immune response is commonly understood as immunologic insufficiency. Primary immunodeficiency diseases are characterized by early clinical realization of immunopathology, have pronounced hereditary character and are inherited, as a rule, by recessive type. Hyper−IgE−syndrome (Job syndrome) is a primary immunodeficiency with autosomal−dominant and autosomal−recessive inheritance. The clinical presentation of Job syndrome is characterized by recurrent skin abscesses, recurrent pneumonia with formation of pneumocele, eczematous dermatitis, increasing blood IgE level. We present a clinical case of hyper−IgE−syndrome in a child with recurrent pneumonias, streptococcal impetigo, eosinophilia, increased blood IgE up to 15114 IU/ml. Our patient had typical phenotypic signs (prominent forehead, deep−set eyes, wide nose bridge, progenia) which are characteristic for Job syndrome. Treatment of the child was performed according to the recommendations for therapy of patients with primary immunodeficiency: medical−hygienic procedures on skin, broad spectrum antibiotics for treatment of bacterial infections, antifungal medicines, immunoglobulin IV. The condition of the child against a background of therapy is satisfactory, physical development corresponds to the age, pneumocele is not formed. The child is under medical supervision of a pediatrician, pulmonologist, allergologist for prevention of severe irreversible complications.
Key words: pneumonia, cytokines, diabetes mellitus, antibiotic therapy.