Common Variable Immunedeficiency (CVID) is a disorder of B-cells, next to IgA deficiency, it is the most common humoral immune deficiency.
Replacement of IgG has changed the occurence of severe infections in patients, but comorbid medical diseases still can present.
CVID affects 1 in 25,000-50,000 people. The most common presentation is sinus and/or pulmonary infections. People with CVID can have low IgG, IgA and IgA and poor or absent antibody production. Diagnosis is made after 4 years of age to typically exclude transient delayed hypogammaglobulinemia of infancy. Other findings are recurrent sinopulmonary infections are recurrent gastorintestinal symptoms and chronic GI infections, lymphoproliferative disorders, autoimmune diseases, T-cell function abnormalities, and increased lymphoma and gastric cancer. 26% of patients only present with infections. The most common complications are bronchiectasis, splenomegaly, iron deficiency and lymphadenopathy.
Optimal management requires monitoring these complications when present. Patients require lifelong IgG therapy and adequate diagnosis of secondary complications that may accompany CVID.
An immunologist will usually be able to work up at diagnose a patient with common variable immune deficiency. This entails taking a careful history of the patient and exploring what kind of infections the patient has had in the past. If common variable immune deficiency is suspected, your immunologist will most likely send you for blood work to help diagnose this condition. Antibodies will be tested, another term for this is immune globlulins, the main one that is found in the blood is IgG. There are 4 subclasses of IgG, 1, 2, 3, 4. Your immunologist may also check your antibody production to different vaccines you have had in the past to see how your immune system has responded to them. This is commonly known as antibody titers. Common titers that are checked are diptheria and tetanus. Your immunologist may also check other titers as well.
If you are diagnosed with Common Variable Immune Deficiency, your immunologist will talk to you about different treatment options, the most common treatment will be replacement of immune globulins with IVIG.