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Akaba T, Kondo M, Toriyama M, et al. Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing. Respir Med Case Rep. 2015;16:41-4doi: 10.1016/j.rmcr.2015.07.002.
Akaba, T., Kondo, M., Toriyama, M., Kubo, A., Hara, K., Yamada, T., Yoshinaga, K., & Tamaoki, J. (2015). Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing. Respiratory medicine case reports, 1641-4. https://doi.org/10.1016/j.rmcr.2015.07.002
Akaba, Tomohiro, et al. "Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing." Respiratory medicine case reports vol. 16 (2015): 41-4. doi: https://doi.org/10.1016/j.rmcr.2015.07.002
Akaba T, Kondo M, Toriyama M, Kubo A, Hara K, Yamada T, Yoshinaga K, Tamaoki J. Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing. Respir Med Case Rep. 2015 Jul 13;16:41-4. doi: 10.1016/j.rmcr.2015.07.002. eCollection 2015. PMID: 26744651; PMCID: PMC4681971.
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Respir Med Case Rep. 2015 Jul 13;16:41-4. doi: 10.1016/j.rmcr.2015.07.002. eCollection 2015.

Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing.

Respiratory medicine case reports

Tomohiro Akaba, Mitsuko Kondo, Midori Toriyama, Ayako Kubo, Kaori Hara, Takeshi Yamada, Kentaro Yoshinaga, Jun Tamaoki

Affiliations

  1. First Department of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
  2. Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.

PMID: 26744651 PMCID: PMC4681971 DOI: 10.1016/j.rmcr.2015.07.002

Abstract

Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency in adults and children. We herein report a case of CVID, who was misdiagnosed with asthma due to wheezing episodes and relatively late onset. A 51-year-old woman had suffered from recurrent upper and lower airway infection for recent 2 years. She repeated wheezing attacks and was treated as asthma exacerbation triggered by infection. She was referred to our hospital for investigation and treatment. Lung function tests showed no reversibility of FEV1 by β-adrenergic agonist, but the increase of V50/V25. Chest CT showed slight to moderate bronchial wall thickening and bronchiectasis. After that, she suffered from pneumonia with wheezing attacks twice a month, and immunodeficiency was strongly suspected. Her blood tests showed marked decreases of all classes of immunoglobulin and nearly lack of memory B cells, NKT cells and plasmacytoid dendritic cells. She was diagnosed with CVID, and was treated with replacement of gammaglobulin. Thereafter, her wheezing episodes with infection were remarkably improved. Because the delay of diagnosis with CVID likely causes poor mortality and morbidity, a possibility of CVID should be considered in patients with frequent asthma-like symptoms due to recurrent airway infection.

Keywords: Airway infection; Bronchial asthma; Common variable immunodeficiency; Hypogammaglobulinemia; Primary immunodeficiency; Wheezes

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