Chronic urticaria and common variable immunodeficiency (CVID): an association to remember

Area of Science:

• Immunology
• Dermatology
• Otolaryngology

Background:

• Idiopathic chronic urticaria is a challenging condition often requiring multidisciplinary management.
• Recurrent infections and otitis media can be presenting symptoms in patients with underlying immune dysregulation.

Observation:

• A 64-year-old woman with refractory chronic urticaria and a history of recurrent infections presented with mucoid otitis media.
• Laboratory investigations revealed decreased immunoglobulin levels and a positive pneumococcal vaccine antibody challenge, confirming common variable immunodeficiency (CVID).

Findings:

• Treatment with intravenous immunoglobulin infusions led to the stabilization of the patient's chronic urticaria.
• The patient's HIV test was negative, highlighting that CVID can occur independently of HIV infection.

Implications:

• This case underscores the importance of considering CVID in patients with treatment-refractory chronic urticaria, particularly those with a history of recurrent infections.
• Early diagnosis and management of CVID with immunoglobulin replacement therapy can significantly improve outcomes for patients with complex immune-related conditions.