Immune function

Overview

Immune Function and Infections

People with Down syndrome are particularly susceptible to infection. Contributing factors to this include both immune and non -immune factors. Respiratory infections are the most common and a frequent cause of morbidity and mortality in people with Down syndrome.Non-respiratory viral, bacterial and fungal infections are generally not more common or severe in Down syndrome.

There is no  specific abnormality of immune function in people with Down syndrome .  Abnormalities reported include lower numbers of  B and T-lymphocytes, particularly naïve lymphocytes, as well as low IgM concentrations Despite these observed abnormalities immune response to infection is usually adequate ,so  non-immune causes for recurrent or persistent infections should be considered. Where non immune causes have been excluded and there are still concerns, specialist immunological investigations and advice should be sought .

 

Autoimmunity

People with Down syndrome have a higher prevalence of certain autoimmune disorders including autoimmune thyroid disease, Type 1 Diabetes Mellitus, coeliac disease and some autoimmune skin conditions such as alopecia and vitiligo.  Onset may be insidious , particular for thyroid disorder and coeliac disease.

Autoimmune disorders can occur earlier in childhood than in the general population , and gender prevalence is equal , unlike the general population.

In view of the high prevalence screening for thyroid disorder is recommended, and although screening for diabetes  or coeliac disease is not recommended , enquiry into possible symptoms should be made at medical reviews, and there should be a low threshold for testing .

 

 

DSMIG Guidance

Thyroid Disorder

Guideline for Basic Essential Medical Surveillance

DSMIG’s evidence-based guideline for basic essential medical surveillance.

Last updated: 2001

 

Presentations at DSMIG Meetings


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Additional Resources

Book Chapter – Immune function,Infection and Autoimmunity

Peter Arkwright and Liz McDermott

in
Down Syndrome – Current Perspectives

ds-current-perspectives-book-coverEdited by Richard Newton , Shiela Puri and Liz Marder