Why Are Patients Referred to A Non HIV Adult Immunodeficiency Clinic?

Abstract

RATIONALE: Fifty thousand diagnosed cases of primary immunodeficiency (PID) exist in the United States with 60% reported in adults. Yet, the indications for referral to an adult PID clinic are not well established. We reviewed the indications for physician referred patients to our adult PID clinic.METHODS: A retrospective review of the indications for referral to an adult PID Clinic. Electronic patient records of active staff in the PID clinic as of March 2006 were reviewed for major indications of referral in accordance with the Mayo Institutional Review Board.RESULTS: Two hundred fifty-three patients (male 91, female 162; median age 51 with range 15-85) were referred for evaluation with each patient having one or more stated indications for referral. Of these there were 300 major reasons for referral with 174 for previous immune findings or diagnoses (non-specific immune findings, hypogammaglobulinemia, IgG subclass deficiency, other specific immune finding, common variable hypogammaglobulinemia, IgA deficiency, previous malignancy, IgM deficiency, elevated total IgE, and rheumatologic disease); 97 for recurrent infections (recurrent sinusitis, non-categorized infection, other specific infection, recurrent pneumonias, and bronchiectasis); and 29 with other non-characterized reasons.CONCLUSIONS: Health care providers refer adult patients to immunology specialists for a variety of concerns. This initial report of indications may help the allergy/immunology community focus attention to specific areas for research and education for adult PID patients. RATIONALE: Fifty thousand diagnosed cases of primary immunodeficiency (PID) exist in the United States with 60% reported in adults. Yet, the indications for referral to an adult PID clinic are not well established. We reviewed the indications for physician referred patients to our adult PID clinic. METHODS: A retrospective review of the indications for referral to an adult PID Clinic. Electronic patient records of active staff in the PID clinic as of March 2006 were reviewed for major indications of referral in accordance with the Mayo Institutional Review Board. RESULTS: Two hundred fifty-three patients (male 91, female 162; median age 51 with range 15-85) were referred for evaluation with each patient having one or more stated indications for referral. Of these there were 300 major reasons for referral with 174 for previous immune findings or diagnoses (non-specific immune findings, hypogammaglobulinemia, IgG subclass deficiency, other specific immune finding, common variable hypogammaglobulinemia, IgA deficiency, previous malignancy, IgM deficiency, elevated total IgE, and rheumatologic disease); 97 for recurrent infections (recurrent sinusitis, non-categorized infection, other specific infection, recurrent pneumonias, and bronchiectasis); and 29 with other non-characterized reasons. CONCLUSIONS: Health care providers refer adult patients to immunology specialists for a variety of concerns. This initial report of indications may help the allergy/immunology community focus attention to specific areas for research and education for adult PID patients.