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 naive 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 .
Updated by Dr Liz Marder , October 2024
DSMIG Guidance
Guideline for Basic Essential Medical Surveillance
DSMIG’s evidence-based guideline for basic essential medical surveillance.
Last updated: 2020
Presentations at DSMIG Meetings
Materials from meetings are available for members only who need to log in to access them. For details on how to become a member click here.
Additional Resources
Book Chapter – Immune function, Infection and Autoimmunity
Peter Arkwright and Liz McDermott
in
Down Syndrome – Current Perspectives
Edited by Richard Newton , Shiela Puri and Liz Marder
Preventing Infection in Children with Down Syndrome
The Down’s Syndrome Association’s Journal, issue 141,
Spring/Summer 2020.
Dr Liz Marder
Immune Dysregulation in Children With Down Syndrome
Dean Huggard, Derek G.Doherty, Eleanor J.Molloy