Sunday, 7 December 2014
Exhibition Hall-Poster Area (Sul America)
Introduction: Commom variable immunodeficiency (CVI) is the second more comom cause of Immunodeficiency. It's prevalence is about 10 000 a 50 000 persons. It's incidente is about the first and second life's decade. Both genders are commited and it can be associated a several phenotypes such a recurrent inlfections,autoimmunity,enteropathy,neoplasms,polyclonal lymphocytic infiltration. The main recurrent infections are those that achieve lungs,paranasal sinuses and gastrointestinal . 60% of the cases of CVI are associated a bronchiectasis. The diagnosis is based on current infections ,reduction of IGG , igm and /or iga below 2 standarts desviations for age , age over 4 years old and excluding others causes of hypogammaglobulinemia.
Objective: The objective is to report the case of a patient who was diagnosed with CVI associated a recurrent pulmonary infections and bronchiectasis.
Description of the case: GOA ,16 years old, 6 previous pneumonias . The first one was when she was 6. She was hospitalized In two of those episodes and also showed weight loss .when she was 15 , the investigation was started. Sweat test and anti HIV were negative.low levels of Immunoglobulins were found (IgG= 20,1 mg/dl; IgM=32,2 mg/dl; IgA=7,2 mg/dl; IgE=1,1 mg/dl). The lymphocite immunophenotyping search was normal for her age (CD3=2939mm3, CD4=693mm3, CD8=2011mm3, CD19=876mm3). Tomografy of the chest presented suggestive areas of severe chronic bronchiectasis. After the exclusion of others hypogammaglobulinemias ' causes and the diagnostic of CVI being confirmed, the treatment was iniciated using intravenous imunoglobulin 400 mg/kg/day and antimicrobial prophylaxis with azitrhomicin. After initiation of treatment, the child didn t have others infections and Gained satisfactory weight. Currently she is being monitorized In a immunology ambulatory.
Conclusion: We want to emphasize need to exclude CVID In patients that presents recurrent pneumonias, mainly when its associated a bronchiectasis.
Objective: The objective is to report the case of a patient who was diagnosed with CVI associated a recurrent pulmonary infections and bronchiectasis.
Description of the case: GOA ,16 years old, 6 previous pneumonias . The first one was when she was 6. She was hospitalized In two of those episodes and also showed weight loss .when she was 15 , the investigation was started. Sweat test and anti HIV were negative.low levels of Immunoglobulins were found (IgG= 20,1 mg/dl; IgM=32,2 mg/dl; IgA=7,2 mg/dl; IgE=1,1 mg/dl). The lymphocite immunophenotyping search was normal for her age (CD3=2939mm3, CD4=693mm3, CD8=2011mm3, CD19=876mm3). Tomografy of the chest presented suggestive areas of severe chronic bronchiectasis. After the exclusion of others hypogammaglobulinemias ' causes and the diagnostic of CVI being confirmed, the treatment was iniciated using intravenous imunoglobulin 400 mg/kg/day and antimicrobial prophylaxis with azitrhomicin. After initiation of treatment, the child didn t have others infections and Gained satisfactory weight. Currently she is being monitorized In a immunology ambulatory.
Conclusion: We want to emphasize need to exclude CVID In patients that presents recurrent pneumonias, mainly when its associated a bronchiectasis.
Bibliography:
1. Conley ME, Notarangelo LD, Etzioni A. Diagnostic criteria for primary immunodeficiencies. Representing PAGID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Clinical immunology. 1999;93(3):190-7.
2. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. British journal of haematology. 2009;145(6):709-27.