Biomarkers for autoimmunity in CVID - summary from 2011 CSACI meeting

This summary was compiled from tweets posted by Dr. Stuart Carr @allergydoc4kidz, the president of the Canadian Society of Allergy and Clinical Immunology (CSACI). The tweets were labeled #CSACI and they reached more than 10,000 people. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future.

Biomarkers for autoimmunity in CVID by Elie Haddad at #CSACI:

Switched memory B cells (IgD- / CD27+) are associated with autoimmunity. A new classification for CVID is based on presence or absence of switched memory B cells (IgD- / CD27+).

There are fewer naïve T cells and Tregs in CVID patients with autoimmunity.

Lower T cell response to PHA and ConA mitogens is associated with higher mortality in CVID (CVID is more than just antibody deficiency).

Treatment of autoimmunity in CVID

IVIG may help if autoimmunity plays a role in CVID (SCIG may be better).

Steroids are effective for treatment of autoimmune diseases in CVID, but problematic due to side effects. Plaquenil is safer but less effective.

One of the best strategy for autoimmunity in CVID is to “kill” B cells with anti-CD20 antibody (Rituximab). Rituximab in CVID achieves good tolerance, it is steroid-sparing, but there is a risk of progressive multifocal leukoencephalopathy.

BMT is an option for treatment of CVID, but little data so far. Outcome of allogeneic stem cell transplantation (ASCT) in adults with common variable immunodeficiency (CVID) (JACI, 2011).

Disclaimer: The text was edited, modified, and added to by me. I was invited to speak on the topic of social media use by the allergists during the 2011 CSACI meeting.