When to suspect A Primary Immunodeficiency

Primary immunodeficiencies are to be suspected in any patient with 

1. Unusual susceptibility for infections, 
2. Severe or early onset autoimmunity and 
3. Susceptibility to malignancies. 

Initially only patients with susceptibility towards infections were evaluated for primary immunodeficiencies. For this purpose, a set of warning signs were suggested by Jeffrey Model Foundation, USA which included recurrent infections, severe infections requiring intravenous antibiotics, unusual infections as well as significant family history. These warning signs are – 

1. Four or more new ear infections within 1 year.
2. Two or more serious sinus infections within 1 year.
3. Two or more months on antibiotics with little effect.
4. Two or more pneumonias within 1 year.
5. Failure of infant to gain weight or grow normally.
6. Recurrent, deep skin or organ abscesses.
7. Persistent thrush in mouth or fungal infection on skin.
8. Need for intravenous antibiotics to clear infections.
9. Two or more deep-seated infections including septicemia. 
10. A family history of PID.