Pulmonary complications of common variable immunodeficiency

Objectives: To review pulmonary complications of common variable immunodeficiency (CVID) and summarize data available on the use of replacement antibody treatment to protect against lung changes. Data Sources: Relevant articles regarding CVID and pulmonary disease identified from PubMed and reference lists of review articles. Study Selection: Key articles were selected by the authors. Results: Patients with CVID often develop acute sinopulmonary infections that can lead to chronic airway inflammation, which can produce substantial morbidity and mortality. Replacement immunoglobulin treatment significantly reduces the reoccurrence of lower airway infections, but the effect on the development of chronic lung damage is not yet clear. Screening examinations, such as pulmonary function testing and high-resolution computed tomography of the chest, can be used to evaluate pulmonary status. Patients with abnormal findings may benefit from more aggressive treatment, including larger doses of immune globulin and the use of prophylactic antibiotics. Conclusions: Pulmonary complications present a significant comorbidity in CVID; monitoring may indicate which patients require more aggressive treatment.