Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 3942-3955
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.3942
From infections to autoimmunity: Diagnostic challenges in common variable immunodeficiency
Ewa Więsik-Szewczyk, Karina Jahnz-Różyk
Ewa Więsik-Szewczyk, Karina Jahnz-Różyk, Department of Internal Medicine, Pulmonology, Allergy and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Warsaw 04-141, Poland
Author contributions: Więsik-Szewczyk E wrote the manuscript; Jahnz-Różyk K supervised the work.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ewa Więsik-Szewczyk, MD, PhD, Doctor, Department of Internal Medicine, Pulmonology, Allergy and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Szaserów 128, Warsaw 04-141, Poland. ewa.w.szewczyk@gmail.com
Received: May 6, 2020
Peer-review started: May 6, 2020
First decision: May 15, 2020
Revised: May 29, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: September 26, 2020
Processing time: 138 Days and 10.1 Hours
Core Tip

Core Tip: Common variable immunodeficiency has to be considered in adults with recurrent respiratory tract infections, bronchiectasis, cytopenia, generalized lymphadenopathy, sarcoid-like symptoms, colitis in whom other conditions were excluded. Low calculated globulin, which is the difference between total protein and albumin levels, suggests hypogammaglobulinemia. Patient with common variable immunodeficiency are referred for commencing replacement immunoglobulin therapy, which should be continued regularly throughout life. It can be administered intravenously, subcutaneously and via the hyaluronidase-facilitated subcutaneous route. One must bear in mind that in patients with hypogammaglo-bulinemia and those treated with polyclonal immunoglobulin G products, serological tests based on determination of antibodies are unreliable.