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Common variable immunodeficiency syndrome: a difficult diagnostic problem

  • C Spyridakou (a1), S Berry (a1) and J Phillipps (a1)

Abstract

Objective:

We present a rare case of an adult male with undiagnosed common variable immunodeficiency syndrome who presented to the ENT department with refractory chronic sinusitis and otitis media with effusion.

Method:

Case report and a review of the international literature concerning common variable immunodeficiency syndrome in adults and upper respiratory tract involvement.

Results:

A 37-year-old male presented to the ENT department with refractory chronic sinusitis and otitis media with effusion. The diagnosis of common variable immunodeficiency syndrome was delayed, and difficult, primarily due to minimal symptoms with no lower respiratory tract involvement and negative past or family medical history.

Conclusion:

Early diagnosis helps to prevent morbidity and even mortality. This article highlights how difficult and important it is to make an early diagnosis of common variable immunodeficiency syndrome. Early diagnosis will only be made by increased awareness of this condition.

Copyright

Corresponding author

Address for correspondence: Dr C Spyridakou, Department of Audiological Medicine, St Ann's Hospital, St Ann's Road, London, N15 3TH, UK. E-mail: chrysasp@hotmail.com

References

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1 Report of a WHO sponsored meeting. Primary immunodeficiency diseases. Immunodefic Rev 1989;1:173205
2 Buckley, RH. Humoral immunodeficiency. Clin Immunol Immunopathol 1986;40:1324
3 Spickett, GP, Misbah, SA, Chapel, HM. Primary antibody deficiency in adults. Lancet 1991;337:281–4
4 Hermaszewski, RA, Webster, AD. Primary hypogammaglobulinaemia: a survey of clinical manifestations and complications. Q J Med 1993;86:3142
5 Polmar, SH. The role of immunologist in sinus disease. J Allergy Clin Immunol 1992;90:511–14; discussion 514–15
6 Ferguson, BJ, Mabry, RL. Laboratory diagnosis. Otolaryngol Head Neck Surg 1997;117:S1226
7 Spickett, GP, Chapel, HM. Report on the audit of patients with primary antibody deficiency in the United Kingdom 1993–1996 Newcastle: Newcastle upon Tyne Hospitals NHS Trust, 1998
8 Blore, J, Haeney, MR. Primary antibody deficiency and diagnostic delay. BMJ 1989;298:516–17
9 Cooney, TR, Huissoon, AP, Powell, RJ, Jones, NS. Investigation for immunodeficiency in patients with recurrent ENT infections. Clin Otolaryngol Allied Sci 2001;26:184–8
10 European Group for Immunodeficiencies. Intravenous gammaglobulin for immunodeficiency: report from the European Group for Immunodeficiencies(EGID). Clin Exp Immunol 1986;65:683–90

Keywords

Common variable immunodeficiency syndrome: a difficult diagnostic problem

  • C Spyridakou (a1), S Berry (a1) and J Phillipps (a1)

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