Lymphoid interstitial pneumonia associated with common variable immunoglobulin deficiency

Area of Science:

• Pulmonology
• Immunology
• Pathology

Background:

• Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by low immunoglobulin levels and impaired B-cell function.
• Patients with CVID are susceptible to recurrent infections and autoimmune phenomena, but pulmonary complications are less common.
• This case highlights an unusual pulmonary manifestation in a CVID patient.

Observation:

• A 30-year-old woman with known CVID presented with incidental abnormal findings on chest radiographs during a routine health screening.
• Chest computed tomography (CT) revealed multiple reticulonodular infiltrates predominantly in the lower lung fields.
• Surgical lung biopsy was performed for definitive diagnosis.

Findings:

• Histopathological examination of the lung biopsy demonstrated a diffuse infiltration of mature small lymphocytes and other mononuclear cells within the lung parenchyma and along the bronchiolar walls.
• These findings were consistent with a diagnosis of lymphoid interstitial pneumonia (LIP).
• No evidence of infection or malignancy was identified.

Implications:

• Lymphoid interstitial pneumonia (LIP) can be a rare pulmonary manifestation of common variable immunodeficiency (CVID).
• Early diagnosis and appropriate treatment, including corticosteroids and immunoglobulin replacement therapy, can lead to clinical and radiographic stabilization.
• This case underscores the importance of considering uncommon pulmonary conditions in immunodeficient patients presenting with respiratory abnormalities.