1054 Pneumonia in common variable immunodeficiency after change in environment

Sunday, 7 December 2014
Exhibition Hall-Poster Area (Sul America)

Guilherme Guimarães, MD , Diivision of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, São Paulo, Brazil

Ana Paula Kazue Beppu, MD , Diivision of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, São Paulo, Brazil

Julia Warchavchik Melardi , Division of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, Brazil

Verônica Reche Rodrigues Gaudino , Division of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, Brazil

Marina Colella Dos Santos , Division of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, Brazil

Maria Da Conceição Santos De Menezes, MD , Division of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, Brazil

Wilma Carvalho Neves Forte, PhD , Division of Allergy and Immunodeficiencies of Santa Casa De São Paulo, Faculty of Medical Sciences of Santa Casa De São Paulo, Brazil

Background:  Common  Variable  Immunodeficiency  (CVID)  is  a  Primary Immunodeficiency characterized by an association of IgG deficiency with IgA  and/or  IgM  deficiency,  and  a  decrease  in  the  function  of  specific antibodies,  discarding  other  causes  of  hipogamaglobulinemia.  The recurrent pneumonia are among the main clinical manifestations of CVID,which appear between 20 and 40 years of age in most cases. The  aim  of  this  study  was  to  analyse  the  possible  relationship  between  environmental changes and the onset of pneumonia in patients with primary CVID.

Methods:  A prospective cross-sectional study was conducted after approval by the Institutional Review Board and written consent of the patients, as protocol number 16622913.5.0000.5479. Eighteen patients with CVID regularly followed in a specialized sector tertiary hospital were studied  for  one  year  (March  2013  to  March  2014).  Inclusion  criteria  were  a  previous diagnosis  of  CVID  with  a  positive  history  of  recurrent  pneumonia.  All  received  monthly replacement with human immunoglobulin. We investigated the clinical characteristics of the onset of pulmonary symptoms by standard questionnaire for all.

Results:  Among the patients studied, 10 were male and 8 female, with mean age of 23 years old (6 to 64 y). The median age for the onset of recurrent pneumonies was 6,5 years (3months to 32y). The mean age of CIVD diagnostic was 11 years (5 to 59 y). The time period from the onset of first pneumonia to the CVID diagnostic was 5,6 years. Five of 18 CVID patients have the positive  relation  between  onset  of  clinical  recurrent  pulmonary  infections after environmental changes.

Conclusions:  We observed that 28% of patients with CVID studied began presenting pneumonia  after  changes in  the  physical  environment,  especially  after living with  a  greater  number  of  individuals.  We believe it  is  important hypothesis CVID in patients with recurrent pneumonia after changes in the physical environment. It  is  possible that part  of  the bimodal  age distribution CVID diagnostic result of changes in the physical environment. More studies are needed in order to know the cause of the clinical manifestations are delayed at CVID.