title: How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?
abstract: BACKGROUND
  The European Society of Immunodeficiency (ESID) developed 6 warning signs to promote the awareness of adult primary immunodeficiency disease (PID).
  
  
  OBJECTIVE
  To screen adult patients for the presence of PID using these 6 warning signs to determine the effectiveness of this protocol.
  
  
  METHODS
  Questions related to the ESID warning signs for adult PID were added to the standard outpatient clinic file system and asked of 3,510 patients who were admitted to our clinic for any reason. Patients with signs and/or suspicion of PID based on their medical history underwent immunologic investigation.
  
  
  RESULTS
  In total, 24 patients were diagnosed as having a PID. The most common reason that patients with PID were admitted was frequent infection (n=18 [75%]), and the most common PID subgroup was common variable immunodeficiency (n=12 [50%]). Twenty patients with PID had at least one positive finding according to the ESID warning signs. Two patients with gastrointestinal concerns and 2 with dermatologic symptoms were also diagnosed as having a PID, although they did not have any of the ESID warning signs.
  
  
  CONCLUSIONS
  The ESID warning signs do not specify the need for symptoms to diagnose a PIDs and do not include a comprehensive list of all signs and symptoms of PIDs. As a result, more than infection-centric questions are needed to identify adult patients with immunodeficiencies.
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Internal Medicine, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey. Electronic address: sevketarslan77@hotmail.com.
authors.forename: Sevket
authors.initials: S
authors.lastname: Arslan
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Internal Medicine, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Ucar
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Internal Medicine, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Ahmet Zafer
authors.initials: AZ
authors.lastname: Caliskaner
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Pediatrics, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Reisli
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Pediatrics, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Sukru Nail
authors.initials: SN
authors.lastname: Guner
authors.affiliation: Division of Immunology and Allergy Diseases, Department of Pediatrics, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Esra Hazar
authors.initials: EH
authors.lastname: Sayar
authors.affiliation: Department of Internal Medicine, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Baloglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000486:Allergy and Immunology; D005060:Europe; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007153:Immunologic Deficiency Syndromes / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D007239:Infections / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000453:epidemiology; D012882:Skin Tests; D012955:Societies, Medical; D055815:Young Adult
chemical_list: D007136:Immunoglobulins