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Immunodeficiency Often Goes Undiagnosed

Even frequently hospitalized patients do not get appropriate specialist care

MONDAY, Aug. 27 (HealthDay News) -- Patients with symptoms of primary immunodeficiency often go undiagnosed, which denies them the opportunity to receive appropriate specialist care, researchers report in the August issue of the Annals of Allergy, Asthma & Immunology.

Ami Mehra, M.D., of the Mount Sinai Medical Center in New York City, and colleagues used a computer algorithm to identify patients with primary immunodeficiency from a database of hospital billing records.

The algorithm identified 296 patients with illnesses indicative of immunodeficiency. Hispanics accounted for 35.8 percent of the cohort, while 27 percent were black and 21.6 percent were white. The patients, who had a median age of 13.3 years, were hospitalized a total of 1,261 times, a median 4.2 times each and had 5,700 diagnoses. Of these patients, 243 were diagnosed with pneumonia, but pulmonary or allergy/immunology subspecialty care was never offered to 45 percent of the patients.

"Outcomes of pneumonia have been shown to improve when treated under specific guidelines in contrast to general care by primary physicians," the authors write. "Relevant to the present patient population, which is predominantly minority, the lack of appropriate subspecialty care is likely to contribute to the observed treatment disparities and increased mortality rates noted in these populations."

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