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Laboratory evaluation of the immune system

Francisco A Bonilla, MD, PhD
E Richard Stiehm, MD
Section Editor
Bruce S Bochner, MD
Deputy Editor
Anna M Feldweg, MD


Immunodeficiency most often comes to clinical attention because of an increase in the incidence or severity of infectious illness beyond what is considered "normal." This topic review will provide a general approach to the laboratory evaluation of the immune system, beginning with screening tests and progressing through the indications for more advanced immunologic testing. Indications for referral to a specialist are discussed, and links to more detailed topics about the different groups of disorders are provided here and throughout the topic. (See "Primary humoral immunodeficiencies: An overview" and "Combined immunodeficiencies" and "Primary disorders of phagocytic function: An overview" and "Laboratory evaluation of neutrophil disorders" and "Overview and clinical assessment of the complement system".)


Immunodeficiency disorders should be considered once the more common causes of recurrent infection have been excluded. The initial approach to a child or adult with recurrent infections is described separately. (See "Approach to the child with recurrent infections" and "Approach to the adult with recurrent infections".)

Immune dysregulation can result in disorders other than recurrent infections including:

Autoimmune disorders, such as autoimmune hemolytic anemia

Inflammatory disorders, such as inflammatory bowel disease or inflammatory arthritis

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Literature review current through: Nov 2017. | This topic last updated: Jan 23, 2017.
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