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[Clinical manifestations and late diagnosis of common variable immunodeficiency]
Wilma Carvalho-Neves Forte1, Helena Morad, Édilon Oliveira
1Santa Casa de São Paulo, Facultad de Ciencias Médicas, São Paulo, Brasil. wilmanevesforte@yahoo.com.br.
Insights
Late diagnosis of Common Variable Immunodeficiency (CVID) in adults is possible. Early treatment with human immunoglobulin replacement significantly improves quality of life for CVID patients.
Area of Science:
- Immunology
- Clinical Medicine
Background:
- Common Variable Immunodeficiency (CVID) is a frequent severe primary immunodeficiency (PID).
- CVID manifestations typically occur in childhood and early adulthood, with rare diagnoses reported after age 50.
- Understanding CVID's varied presentation is crucial for timely diagnosis.
Observation:
- A 58-year-old male presented with recurrent infections since age 35.
- Diagnostic tests revealed hypogammaglobulinemia (decreased IgG, IgA, and specific antibodies).
- No other causes for hypogammaglobulinemia were identified.
Findings:
- A diagnosis of Common Variable Immunodeficiency (CVID) was established in a patient over 50.
- Treatment involved human immunoglobulin replacement therapy.
- Personal and environmental hygiene reinforcement was also implemented.
Implications:
- Late-onset CVID diagnoses, though infrequent, are critical for patient recovery.
- Human immunoglobulin replacement therapy led to a significant improvement in the patient's quality of life.
- This case highlights the importance of considering CVID in older adults presenting with recurrent infections.
Background:
Common Variable Immunodeficiency (CVID) is the most frequent type of severe primary immunodeficiency (PID). Clinical manifestations of CVID occur at any age; nevertheless, they are more frequent between the age of 6 and 10 years, and between the age of 20 and 40 years. In medical literature, there are hardly any diagnostic reports on CVID after 50 years of age.
Clinical Case:
A 58-year-old man with a clinical history of repeated infections since the age of 35. The tests showed a decrease in IgG, IgA, and specific antibodies, without any other causes of hypogammaglobulinemia. The CVID diagnosis was made and the patient received treatment with human immunoglobulin replacement and a reinforcement of personal and environmental hygiene. The patient stopped presenting repeated infections.
Conclusion:
Diagnoses made after the age of 50, although they're late, they are fundamental to the recovery of the patient. In the referred case, replacement with human immunoglobulin allowed an improvement in the quality of life.
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