Publication details

Cytomegalovirus Disease in Patients with Common Variable Immunodeficiency: Three Case Reports

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Authors

KRALICKOVA Pavlina MALA Eva VOKURKOVA Doris KRCMOVA Irena PLISKOVA Lenka STEPANOVA Vlasta BARTOS Vladimir KOBLIZEK Vladimir TACHECI Ilja BURES Jan BROZIK Jan LITZMAN Jiří

Year of publication 2014
Type Article in Periodical
Magazine / Source International archives of allergy and immunology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1159/000355957
Field Immunology
Keywords Common variable immunodeficiency; Cytomegalovirus; Mycobacteriosis; Opportunistic infection; Pneumonitis; Enteritis
Description Common variable immunodeficiency (CVID) is the most frequent clinically relevant primary immunodeficiency and shows enormous heterogeneity in clinical presentation. Despite clinical immunodeficiency, opportunistic infections are not a typical manifestation of CVID. A retrospective study of 32 patients followed up for 335 patient-years was performed to determine the frequency of cytomegalovirus (CMV) disease. Symptomatic CMV infection was documented in 3 CVID patients. Patients No. 1 and 2 suffered from CMV pneumonia, with complications due to atypical mycobacteriosis in patient No. 1. Patient No. 3 suffered from CMV enteritis. A history of cancer and chronic hepatitis C infection (patient No. 1), immunosuppressive therapy for interstitial lung disease (patient No. 2) and serious enteropathy complicated with malnutrition (patient No. 3) may have contributed to the complications despite only mild abnormalities in T-cell subpopulations. The direct detection of CMV in bronchoalveolar lavage, stool or tissue samples was the most beneficial diagnostic laboratory method, whereas the detection of CMV DNA in blood did not produce positive results. Adequate treatment of CMV disease led to significant clinical improvement in all 3 patients. The frequency of CMV disease appears to be higher than previously described. In our experience, the probability of opportunistic infections in CVID patients increases with secondary comorbidities and their management.
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