Here is the suggested Common Variable Immunodeficiency (CVID) workup, from AAAAI Ask the Expert:
Initial evaluation of CVID
- complete antibody workup for both several protein and anti-carbohydrate antibodies
- T and B and NK cells. Many centers do not routinely do mitogens and antigens, and routine HIV tests
- if liver tests are abnormal, one could do hepatitis tests
- CBD and CMP
- if there is a suspicion of lung disease, complete PFTs and a chest CT should be considered
- for suspicion of GI disease, malabsorption tests may be needed
Followup of CVID
While on IVIG or SCIG replacement, followup tests can included IgG level at 6 month intervals. If the patient only comes in only each year, then yearly IgG, CBC and CMP can be considered. Also, consider complete PFTs yearly. CT can be considered every 3 or 4 years, only if lung disease suspected or lung function is not normal.
Typical pattern of immunoglobulin levels (IgG, IgA, IgM) in humoral immunodeficiency. Click here to enlarge the table.
Primary immunodeficiency disorders (PIDD) (click to enlarge the image).
Laboratory evaluation of patients with common variable immunodeficiency - AAAAI Ask the Expert, 2012.