Role of T-B-NK cell with naive and memory cell markers in the diagnosis of primary immunodeficiency disorders in a tertiary care hospital

The common heterogeneous group of inherited diseases is primary immune deficiency disorders (PIDDs), which affect the immune system. For the diagnosis of these disorders, the role of immunological cell markers is studied by a flow cytometry-based technology, which has emerged as a useful and quickly facilitated understanding of the human immune system. The utility of this well-known technology was recently proved through our study in a tertiary care hospital. We have carried out this study on 62 clinically suspected PID cases referred by the pediatricians to the Department of Microbiology & Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), and Dhaka from March 2020 to January 2021. The peripheral venous blood samples from the suspected PID patients were screened for immunophenotypic patterns. The surface markers of lymphocytes, including the T-B-NK cell markers, along with CD45RO, CD45RA, CD27, and IgD markers, were detected by flow cytometric analysis. Serum immunoglobulin classes were estimated in all study cases by nephelometry. Majority of the clinically suspected PIDD cases (14, or 23%) were diagnosed by using CD45RA, CD45RO, CD27, and IgD markers along with the T-B-NK cell markers and serum immunoglobulin classes. The majority of them (9 out of 64.28%) were predominantly antibody deficiency disorders, and 5 (35.71%) were combined immunodeficiency disorders. Three patients of combined immunodeficiency (CID) other than severe combined immunodeficiency (SCID) and two patients of common variable immune deficiency (CVID) were diagnosed exclusively by CD45RA, CD45RO, CD27, and IgD markers. In the study, the use of CD45RA, CD45RO, CD27, and IgD markers proved to facilitate early detection of CVID and SCID cases, where T-B-NK cell markers were found normal, thus supporting the clinical decisions for better outcomes for the patients.