Signs and symptoms of CID

Children with CID may seem well at birth and for the first few months or years of life. This is because they are partly protected by antibodies passed from mother to baby across the placenta during the last few months of pregnancy.  They also have partially functional immunity of their own and may be able to respond to some extent to vaccinations and germs they encounter.

CID can affect children in many different ways. They are likely to suffer infections
more frequently than other infants. Ordinary problems, such as coughs and
colds, may seem more severe and last longer than would be expected, requiring
repeated and prolonged courses of treatment. Skin rashes (such as eczema),
a wheezy chest or breathlessness and even food allergies may be present.
Sometimes children with CID may have a poor appetite, have chronic diarrhoea
and fail to grow and gain weight normally, even if no definite infection is found.

CID can make it difficult for children to deal with some common viruses (for
example, chickenpox and the glandular fever virus (caused by Epstein-Barr Virus
(EBV)). Germs in the environment that don’t cause disease in healthy individuals
can sometimes cause serious and life-threatening illness in a child with CID. In
particular, Pneumocystis jirovecii, Aspergillus and Cytomegalovirus can cause
severe infection (most frequently pneumonia). Cryptosporidium (sometimes
found in drinking water) can cause severe diarrhoea and sometimes liver disease
in children with CID. Thrush in the mouth and/or nappy area may be severe
and persistent.

Apart from infections, some children with CID cannot regulate their immune
system correctly. They may not be able to ‘turn down’ an immune response
triggered by infection, so ending up with a vicious cycle of fever and
inflammation called haemophagocytic lymphohistiocytosis (HLH). The immune
system might also get turned against the child’s own body, resulting in
autoimmune diseases, such as arthritis, bowel problems or a low blood count.

Reviewed November 2017