Granulomatous disease in common variable immunodeficiency

Clin Immunol. 2009 Nov;133(2):198-207. doi: 10.1016/j.clim.2009.05.001. Epub 2009 Aug 28.

Abstract

Granulomatous disease occurs in 8-22% of patients with common variable immunodeficiency (CVID). We examined the clinical and immunologic information of all 37 of 455 (8.1%) CVID subjects with this complication. The median age at diagnosis of CVID was 26 (2-59). 14 had granulomas 1-18 years before diagnosis of CVID. In 6 detection of granulomas coincided with this diagnosis; for 17, granulomas were documented later. 54% had lung granulomas, 43% in lymph nodes and 32% in liver. 54% of the group had had autoimmune diseases, mostly immune thrombocytopenia and hemolytic anemia. 24% had had a splenectomy. Nineteen (51.3%) required steroid treatment for granulomas; other immune suppressants were used in some. Over 25 years 28.5% died (median age 37.5), but not significantly more when compared to our CVID patients without granulomas (19.8%). Those with lung granulomas had similar mortality to those with granulomas in other tissues.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antibodies / blood
  • Antibodies / immunology
  • Autoimmune Diseases / etiology
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / therapy
  • B-Lymphocytes / cytology
  • B-Lymphocytes / immunology
  • CD4-CD8 Ratio
  • Child
  • Child, Preschool
  • Common Variable Immunodeficiency / complications*
  • Common Variable Immunodeficiency / immunology
  • Female
  • Follow-Up Studies
  • Granuloma / drug therapy
  • Granuloma / etiology*
  • Granuloma / immunology
  • Granuloma / mortality
  • Granuloma / pathology
  • Humans
  • Lung / pathology
  • Lymphocyte Activation / drug effects
  • Lymphocyte Activation / immunology
  • Male
  • Middle Aged
  • Mitogens / pharmacology
  • Splenectomy
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology
  • Young Adult

Substances

  • Antibodies
  • Mitogens