Miloš Jeseňák, Zuzana Rennerová, Peter Bánovčin
Combined T and B cellular immunodeficiencies present approximately 20 % of all inherited immunodeficiencies. Although they are rarer than humoral deficiencies, their clinical course is more severe and requires soon diagnosis with subsequent therapy. They are manifested clinically very soon after birth or till the end of the second year of life. The most characteristic clinical signs of these primary immunodeficiencies are: chronic or recurrent severe viral, bacterial, fungal or protozoa infections, dissemination of BCG-vaccination strain, infections caused by opportunistic pathogens, chronic persisting diarrhoea, failure to thrive, extensive thrush, hepatosplenomegaly, lymphadenopathy or various chronic dermatoses. The most important disease from this group is severe combined immunodeficiency. Therapy is complex and consists from antimicrobial treatment, substitution of immunoglobulins (in case of combined deficiency), transplantation of stem cells and in selected cases of gene therapy.