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How to Identify Common Variable Immunodeficiency Patients Earlier: General Practice Patterns.

Frederik V Ilkjær1,2, Line D Rasmussen3, Raquel Martin-Iguacel3

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Summary
This summary is machine-generated.

Patients with common variable immunodeficiency (CVID) have more frequent general practitioner (GP) visits before diagnosis. Increased consultation frequency and specific examinations significantly raise the risk of a CVID diagnosis, particularly in younger adults.

Keywords:
CVIDPIDconsultationsdiagnostic delayindicatorsprimary health care

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Area of Science:

  • Immunology
  • Primary Care Medicine
  • Diagnostic Delay

Background:

  • Diagnostic delay is a significant challenge in managing common variable immunodeficiency (CVID).
  • Understanding general practitioner (GP) consultation patterns preceding CVID diagnosis is crucial for early detection.

Purpose of the Study:

  • To investigate the frequency and nature of GP consultations in individuals diagnosed with CVID within three years prior to diagnosis.
  • To assess the association between consultation patterns and the risk of a CVID diagnosis.

Main Methods:

  • A nested case-control study utilized national registers from 1997-2013.
  • 132 adult CVID patients were matched with 5940 controls.
  • Conditional logistic regression analyzed the odds ratios (OR) and 95% confidence intervals (95%CI) for diagnosis risk.

Main Results:

  • CVID patients had over double the median number of GP consultations compared to controls in the three years before diagnosis.
  • A higher number of consultations, especially 9-15 versus 1-4 in the third year pre-diagnosis, significantly increased CVID diagnosis risk (OR 5.0 for ages 18-40).
  • Specific examinations like blood tests for inflammation/infection and pulmonary function tests were associated with increased odds of a CVID diagnosis.

Conclusions:

  • The risk of CVID diagnosis is strongly linked to both the frequency of GP consultations and the types of examinations performed.
  • Common variable immunodeficiency (CVID) should be considered in the differential diagnosis for patients with frequent consultations, particularly those under 40.