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Morphology of Lymph node • Follicular hyperplasia • Follicular involution & lymphocyte depletion-burnt out lymph nodes • Opportunistic infections • lymphomas Clinical features Mycobacterium Avium Intracellulare (MAI) Cryptococcosis Candidiasis Brain:primary lymphoma in AIDS: Diagnosis of HIV infection: • Detect antibodies, antigens, or viral nucleic acids • (p 24) • ELISA • CD4 counts. Primary immunodeficiencies • Genetically determined • Adaptive immunity defects -Humoral and cellular arms of immunity. Interaction between B &T cells –overlap of symptoms • Innate immunity- Non specific host defense mechanisms –complement, NK cells ,phagocytes Some primary immunodeficiencies Name Defect Pathogenesis Clinical features X linked afammaglobuline mia of Bruton Mutation of cytoplasmic b cell tyrosine kinase (BTK gene) Failure of B cell precusors to mature to B cells.→↓ B lymphos Deficiency of immunoglobulins Failure of opsonisation of bacteria >6 months males Bacterial Viral infections Common variable immunodeficiency Hetrogenous Hypogammaglobulinemia,all esp IgG Inability of B cells to mature to plasma cells Childhood /adolescence Both sexes Bacterial &Viral infectios DiGeorge syndrome Failure of development of 3& 4 pharyngeal pouches Thymic hypoplasia T cell defects Viral & fungal infections Severe combined immunodefienenc y diseases (SCID) X linked SCID-γ chain mutation Adenosisne deaminase deficiency Others Defective humoral and cell-mediated immune response Childhood /adolescence Both sexes Antibody deficiency infections Wiskott –Aldrich syndrome ??? Secondary depletion of T lymphocytes Eczema Thrombocytopenia infections THANK YOU