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Primary immunodeficiencies (PID) are traditionally considered childhood diseases; however, adults account for 35% of all patients with PID. Antibody deficiencies, especially Common Variable Immunodeficiency (CVID), which have their peak incidence in adulthood, require a high suspicion index. Even though the estimated frequency of CVID is not high (1:25,000), high rates of under diagnosis and under reporting are very likely. The delay in diagnosis increases the morbidity and mortality; therefore, adult physicians should be able to suspect, identify and initiate management of individuals with PID. Here we report the case of a 37 year-old man presenting to the emergency room with dyspnea, fever and cough; he developed respiratory failure requiring mechanical ventilation. He complained of recurring pneumonia associated with widespread bronchiectasis since he was 18 years old. Serum immunoglobulins quantification showed severe hypogammaglobulinemia (total IgG <140 mg/dL; total IgA, 2.9 mg/dL; and total IgM <5 mg/dL). Treatment with Human Intravenous Immunoglobulin (IVIG) 10% was started, and with antibiotic treatment for severe pneumonia (during 14 days) was also prescribed. His clinical evolution has been favorable after one year follow-up. Common Variable Immunodeficiency (CVID) diagnosis was made.

 

Andres Felipe Zea-Vera, Department of Internal Medicine, Faculty of Health, Universidad del Valle, Cali, Colombia Research Group VIREM, School of Basic Sciences, Faculty of Health, Universidad del Valle, Cali, Colombia.

-Department of Internal Medicine, Faculty of Health, Universidad del Valle. Cali, Colombia.

-Research Group VIREM, School of Basic Sciences, Faculty of Health, Universidad del Valle. Cali, Colombia.

Olga Lucia Agudelo-Rojas, Research Group VIREM, School of Basic Sciences, Faculty of Health, Universidad del Valle, Cali, Colombia.

Research Group VIREM, School of Basic Sciences, Faculty of Health, Universidad del Valle. Cali, Colombia.
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Received 2014-10-30
Accepted 2015-03-25
Published 2015-03-30