Chapter 59: Immune Disorders

Laboratory assessment emerges as a critical clinical skill, with emphasis on antinuclear antibody testing for detecting autoimmune activity, anti-double-stranded DNA antibodies for monitoring systemic lupus erythematosus, and CD4+ cell counts for tracking human immunodeficiency virus progression and determining susceptibility to opportunistic infections. The chapter categorizes hypersensitivity reactions from mild allergic responses amenable to antihistamine therapy through severe anaphylactic reactions requiring immediate epinephrine administration, airway management, and hemodynamic support, with particular attention to latex allergy as an occupational hazard for healthcare workers. Immunodeficiency disorders span congenital conditions and acquired presentations including AIDS, requiring meticulous infection prevention protocols, aseptic technique application, and psychosocial support addressing the profound impact of chronic immunosuppression. Autoimmune diseases including systemic lupus erythematosus with characteristic photosensitivity and malar rash, scleroderma with progressive fibrosis affecting swallowing and gastrointestinal function, polyarteritis nodosa as systemic vasculitis, pemphigus with autoimmune-mediated blistering, and Goodpasture's syndrome affecting pulmonary and renal tissues receive detailed coverage with evidence-based interventions including corticosteroids, immunosuppressive agents, and plasmapheresis for removing pathogenic antibodies. Posttransplantation immunodeficiency necessitates careful immunosuppressant medication management and vigilant rejection monitoring. The chapter concludes with Lyme disease recognition including the characteristic bull's-eye rash, systematic antibiotic protocols, and prevention strategies targeting tick exposure reduction, providing essential preparation for clinical decision-making in immune-related conditions.