Lung function and HRCT deteriorate in CVID patients despite treatment with immunoglobulins

Patients with common variable immunodeficiency (CVID) have low serum IgG, IgA, and/or IgM levels and recurrent airway infections. Radiologic pulmonary abnormalities and impaired function are common complications.

In a retrospective, longitudinal study of 54 patients with CVID already treated with immunoglobulins, the researches examined changes of lung function and findings on high-resolution computed tomography (HRCT), obtained at 2 time points 2 to 7 years apart (T0 to T1).


Immunoglobuln (Ig) structures. Image source: Wikipedia.

Despite a mean (SD) serum IgG level of 7.6 (2.3) g/L for all the patients during the entire study period, lung function decreased from T0 to T1. The combination of a low serum IgA level and serum MBL was associated with the presence of bronchiectasis and lower lung function and with worsening of several HRCT abnormalities. Increased serum levels of TNF-alpha were related to deterioration of gas diffusion.

A mean serum IgG level less than 5 g/L between T0 and T1 was associated with worsening of linear and/or irregular opacities seen on HRCT.

For a period of 4 years, lung function and HRCT deteriorated in CVID patients treated with immunoglobulins.

References:
Development of pulmonary abnormalities in patients with common variable immunodeficiency: associations with clinical and immunologic factors. Gregersen S, Aaløkken TM, Mynarek G, Fevang B, Holm AM, Ueland T, Aukrust P, Kongerud J, Johansen B, Frøland SS. Ann Allergy Asthma Immunol. 2010 Jun;104(6):503-10.
CVID patients (higher radiation sensitivity) might be evaluated by chest MRI - a radiation-free alternative to CT http://goo.gl/0ohqb

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