Pulmonary Computed Tomography Screening Frequency in Primary Antibody Deficiency

Area of Science:

• Immunology
• Pulmonology
• Radiology

Background:

• Primary antibody deficiency (PAD) patients have high rates of pulmonary complications, increasing morbidity and mortality.
• Computed tomography (CT) screening is recommended, but predictive risk factors for pulmonary morbidity are lacking.

Purpose of the Study:

• To identify patients with primary antibody deficiency (PAD) at risk for pulmonary complications.
• To guide the frequency of regular CT screening for these patients.

Main Methods:

• A retrospective, longitudinal cohort study of PAD patients with a median follow-up of 7.4 years.
• CT scans were scored using the modified Brody-II system.
• Clinical and laboratory data were collected, and risk factors were identified using univariate and multivariable logistic regression.

Main Results:

• X-linked agammaglobulinemia (XLA), recurrent airway infections (≥2.5/year), and baseline airway disease (AD) were independent risk factors for AD progression.
• Common variable immunodeficiency and increased CD4 effector/memory cells were risk factors for interstitial lung disease (ILD) progression.
• Pre-existent AD or ILD scores predicted progression in most affected patients.

Conclusions:

• Identified risk factors can help distinguish PAD patients at risk for AD and ILD presence and progression.
• These findings may inform future screening strategies for pulmonary complications in PAD.
• Prospective validation of these risk factors is necessary.