Allergic-like disorders and asthma in patients with common variable immunodeficiency: a multi-center experience

Abstract

Objective

Common variable immune deficiency (CVID) encompasses a variety of diseases characterized by disturbed immunoglobulin (Ig) production and various immune dysregulations. Scarce data are available regarding relationships between CVID and allergic diseases. Here we examined possible associations between allergies and CVID.

Methods

For this multicenter study, we prospectively enrolled 79 adult CVID patients (≥18 years) who were diagnosed and treated between 2002–2017 at the Hadassah-Hebrew University and Shaare Zedek Medical Centers, Jerusalem, Israel. These patients were examined for allergic manifestations. Patient evaluation comprised medical history, physical examination, skin allergen testing, complete blood count, serum immunoglobulins, IgE levels, and pulmonary function tests.

Results

After implementing exclusion criteria, 29 patients were included in the final analysis. Allergic-like disorders were diagnosed in 65% of CVID patients with non-elevated serum IgE levels. Moreover, allergic CVID patients exhibited a higher prevalence of bronchiectasis on chest CT. Autoimmunity was diagnosed in 41.3% of CVID subjects. The type I allergy detected in our study was non-IgE mediated.

Conclusions

Timely diagnosis and stratification of allergy in CVID patients is expected to improve their outcome and quality of life, as well as promote appropriate treatment and better management of pulmonary exacerbations.

Keywords:

• Common variable immune deficiency
• allergic disorders
• asthma
• incidence rate
• clinical characteristics
• diagnosis

Authorship contribution

LR*- data collection, physical examination of patients and writing of manuscript; OS* – study design, immune consultation and manuscript revisions, OT, EK- data collection; YR, AT- immune consultation and manuscript review, AYH- immune consultation, YT - Principle investigator, research initiator and study supervision. * Equally contributed and should be considered as first authors.

Declaration of interest

All authors have no conflict of interest.

Data availability

The data used to support the finding of this study are included within the article and supplemental material.