Main Article Content
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.
Salzer U, Warnatz K, Hartmut PH. Common variable immunodeficiency - an update. Arthritis Res Ther. 2012; 14(5): 223–34.
Rosel AL, Scheibenbogen C, Schliesser U, Sollwedel A, Hoffmeister B, Hanitsch L, et al. Classification of common variable immunodeficiencies using flow cytometry and a memory B-cell functionality assay. J Allergy Clin Immunol. 2014; 135(1): 197–208.
Cunningham-Rundles C. The many faces of common variable immunodeficiency. Hematology Am Soc Hematol Educ Program. 2012; 2012: 301–5.
Modell V, Gee B, Lewis DB, Orange JS, Roifman CM, Routes JM, et al. Global study of primary immunodeficiency diseases (PI)--diagnosis, treatment, and economic impact: an updated report from the Jeffrey Modell Foundation. Immunol Res. 2011; 51(1): 61–70.
Riminton DS, Limaye S. Primary immunodeficiency diseases in adulthood. Intern Med J. 2004; 34(6): 348–54.
Kumar Y, Bhatia A. Comment on Common variable immunodeficiency in adults: current diagnostic protocol and laboratory measures. Expert Rev Clin Immunol. 2013; 10(2): 187–8
Fernandez Romero DS, Juri MC, Paolini MV, Malbran A. Common variable immunodeficiency: Epidemiology and clinical manifestations in 69 patients. Med (B Aires). 2013; 73(4): 315–23.
Shoemark A, Ozerovitch L, Wilson R. Aetiology in adult patients with bronchiectasis. Respir Med. 2007; 101(6): 1163–70.
Metersky ML. The initial evaluation of adults with bronchiectasis. Clin Chest Med. 2012; 33(2): 219–31.
Webster AD. Clinical and Immunological Spectrum of Common Variable Immunodeficiency (CVID). Iran J Allergy Asthma Immunol. 2004; 3(3): 103–13.
Cunningham-Rundles C. Key aspects for successful immunoglobulin therapy of primary immunodeficiencies. Clin Exp Immunol. 2011; 164(2): 16–9.
Cunningham-Rundles C. How I treat common variable immune deficiency. Blood. 2010; 116(1): 7–15.
Gathmann B, Mahlaoui N, CEREDIH, Gérard L, Oksenhendler E, Warnatz K, et al. Clinical picture and treatment of 2212 patients with common variable immunodeficiency. J Allergy Clin Immunol. 2014; 134(1): 116–26.
Montoya CJ, Henao J, Salgado H, Olivares MM, López JA, Rugeles C, et al. Diagnóstico fenotípico de las inmunodeficiencias primarias en Antioquia. Biomedica. 2002; 22: 510–8.
- Andres Felipe Zea-Vera, Immunocompetence in adults: more than HIV negative , Colombia Medica: Vol. 47 No. 3 (2016)
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use