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Screening patients affected by common variable immunodeficiency

S Masieri1, M P Orlando, A Ciofalo

  • 1ENT Clinic, University La Sapienza, Rome, Italy.

Annals of the New York Academy of Sciences
|June 9, 1998
PubMed
Summary
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Chronic immunoglobulin therapy for chronic variable immunodeficiency (CVI) patients did not prevent ENT disorders, likely due to nasal hyperreactivity. Early ENT screening and treatment are recommended for CVI patients.

Area of Science:

  • Immunology
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Chronic variable immunodeficiency (CVI) patients often experience recurrent infections.
  • Immunoglobulin therapy is standard for CVI but its effect on ENT health is unclear.

Purpose of the Study:

  • To evaluate the prevalence of ENT disorders in CVI patients undergoing chronic immunoglobulin therapy.
  • To assess the efficacy of immunoglobulin therapy in managing CVI-related ENT manifestations.

Main Methods:

  • A comprehensive ENT screening was performed on 22 CVI patients.
  • Methods included physical exams, endoscopy, mucociliary transport tests, rhinomanometry, olfactory tests, and imaging.
  • Patients were compared to healthy controls where applicable.

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Main Results:

  • High prevalence of dysphagia (91%), nasal symptoms (77%), hearing loss (57%), rhinitis/pharyngitis (86%), and sinusitis (five patients).
  • Impaired mucociliary transport (longer MTT) and reduced nasal resistance were observed in CVI patients.
  • Nasal hyperreactivity, indicated by positive cold water tests, was more frequent in patients.

Conclusions:

  • Chronic immunoglobulin therapy does not appear to resolve or prevent ENT disorders in CVI patients.
  • Nasal hyperreactivity may be a significant factor contributing to persistent ENT issues.
  • Regular ENT evaluations and prompt treatment are crucial for managing CVI patients.