Basic and Clinical ImmunologyEfficacy of intravenous immunoglobulin in the prevention of pneumonia in patients with common variable immunodeficiency☆,☆☆
Section snippets
Patients
Mount Sinai Medical Center has been a referral center for patients with primary immunodeficiency, and 280 patients with CVID have been seen over a period of 15 years. Data on these patients are maintained and assigned a number at the time of referral. For this study, the charts of the 50 most recently referred patients have been reviewed. All of the 50 patients met the definition for CVID.6, 7 Antibody deficiency was verified by means of decreased antibody production to 2 or more vaccines,
Episodes of pneumonia before treatment with IVIG
Forty-two (84%) of 50 patients had at least one episode of pneumonia verified on chest radiography before diagnosis of CVID and IVIG treatment, whereas the remaining 8 (16%) had never had pneumonia. Of these 42 patients, the number of episodes of pneumonia could be determined for 31. Fifteen (48%) of these 31 patients had one episode of pneumonia, 5 patients had 2 episodes, 6 had 3 episodes, 1 had 4 episodes, and the rest had more than 5 episodes. For these 31 subjects, the average number of
Discussion
Pneumonia is common in patients with CVID. Forty-two (84%) of 50 patients with CVID had at least one episode of pneumonia before diagnosis. Watts et al10 found that 28 (87.5%) of 32 patients with CVID (adults and children) had an average of 3 or more episodes of pneumonia each, and 14 had bronchiectasis over a period of 27 years, which included immunoglobulin pretreatment and treatment years. In another study 41 (75%) of 55 patients with CVID had at least one episode of pneumonia before
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Supported by the Immune Deficiency Foundation (Towson, Md), National Institutes of Health grants AI46732 and AI48693, and Food and Drug Administration grant 001679.
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Reprint requests: Charlotte Cunningham-Rundles, MD, PhD, Department of Clinical Immunology, 1425 Madison Ave, The Mount Sinai School of Medicine, New York, NY 10029.