CVID Associated with Systemic Amyloidosis

Common variable immunodeficiency (CVID) is a frequent primary immune deficiency (PID), which consists of a heterogeneous group of disorders and can present with recurrent infections, chronic diarrhea, autoimmunity, chronic pulmonary and gastrointestinal diseases, and malignancy. Secondary amyloidosi...

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Main Authors: Saliha Esenboga, Deniz Çagdas Ayvaz, Arzu Saglam Ayhan, Banu Peynircioglu, Ozden Sanal, Ilhan Tezcan
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Immunology
Online Access:http://dx.doi.org/10.1155/2015/879179
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author Saliha Esenboga
Deniz Çagdas Ayvaz
Arzu Saglam Ayhan
Banu Peynircioglu
Ozden Sanal
Ilhan Tezcan
author_facet Saliha Esenboga
Deniz Çagdas Ayvaz
Arzu Saglam Ayhan
Banu Peynircioglu
Ozden Sanal
Ilhan Tezcan
author_sort Saliha Esenboga
collection DOAJ
description Common variable immunodeficiency (CVID) is a frequent primary immune deficiency (PID), which consists of a heterogeneous group of disorders and can present with recurrent infections, chronic diarrhea, autoimmunity, chronic pulmonary and gastrointestinal diseases, and malignancy. Secondary amyloidosis is an uncommon complication of CVID. We report an unusual case of a 27-year-old male patient who presented with recurrent sinopulmonary infections, chronic diarrhea, and hypogammaglobulinemia and was diagnosed with CVID. The patient was treated with intravenous immunoglobulin (IVIg) therapy once every 21 days and daily trimethoprim-sulfamethoxazole for prophylaxis. Two years after initial diagnosis, the patient was found to have progressive decline in IgG levels (as low as 200–300 mg/dL) despite regular Ig infusions. The laboratory tests revealed massive proteinuria and his kidney biopsy showed accumulation of AA type amyloid. We believe that the delay in the diagnosis of CVID and initiation of Ig replacement therapy caused chronic inflammation due to recurrent infections in our patient and this led to an uncommon and life-threatening complication, amyloidosis. Patients with CVID require regular follow-up for the control of infections and assessment of adequacy of Ig replacement therapy. Amyloidosis should be kept in the differential diagnosis when managing patients with CVID.
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spelling doaj-art-a2bc9d388d62422fb1ab3900d09fb5032025-08-20T02:20:37ZengWileyCase Reports in Immunology2090-66092090-66172015-01-01201510.1155/2015/879179879179CVID Associated with Systemic AmyloidosisSaliha Esenboga0Deniz Çagdas Ayvaz1Arzu Saglam Ayhan2Banu Peynircioglu3Ozden Sanal4Ilhan Tezcan5Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyDivision of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyDepartment of Pathology, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyDepartment of Medical Biology and Genetics, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyDivision of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyDivision of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara, TurkeyCommon variable immunodeficiency (CVID) is a frequent primary immune deficiency (PID), which consists of a heterogeneous group of disorders and can present with recurrent infections, chronic diarrhea, autoimmunity, chronic pulmonary and gastrointestinal diseases, and malignancy. Secondary amyloidosis is an uncommon complication of CVID. We report an unusual case of a 27-year-old male patient who presented with recurrent sinopulmonary infections, chronic diarrhea, and hypogammaglobulinemia and was diagnosed with CVID. The patient was treated with intravenous immunoglobulin (IVIg) therapy once every 21 days and daily trimethoprim-sulfamethoxazole for prophylaxis. Two years after initial diagnosis, the patient was found to have progressive decline in IgG levels (as low as 200–300 mg/dL) despite regular Ig infusions. The laboratory tests revealed massive proteinuria and his kidney biopsy showed accumulation of AA type amyloid. We believe that the delay in the diagnosis of CVID and initiation of Ig replacement therapy caused chronic inflammation due to recurrent infections in our patient and this led to an uncommon and life-threatening complication, amyloidosis. Patients with CVID require regular follow-up for the control of infections and assessment of adequacy of Ig replacement therapy. Amyloidosis should be kept in the differential diagnosis when managing patients with CVID.http://dx.doi.org/10.1155/2015/879179
spellingShingle Saliha Esenboga
Deniz Çagdas Ayvaz
Arzu Saglam Ayhan
Banu Peynircioglu
Ozden Sanal
Ilhan Tezcan
CVID Associated with Systemic Amyloidosis
Case Reports in Immunology
title CVID Associated with Systemic Amyloidosis
title_full CVID Associated with Systemic Amyloidosis
title_fullStr CVID Associated with Systemic Amyloidosis
title_full_unstemmed CVID Associated with Systemic Amyloidosis
title_short CVID Associated with Systemic Amyloidosis
title_sort cvid associated with systemic amyloidosis
url http://dx.doi.org/10.1155/2015/879179
work_keys_str_mv AT salihaesenboga cvidassociatedwithsystemicamyloidosis
AT denizcagdasayvaz cvidassociatedwithsystemicamyloidosis
AT arzusaglamayhan cvidassociatedwithsystemicamyloidosis
AT banupeynircioglu cvidassociatedwithsystemicamyloidosis
AT ozdensanal cvidassociatedwithsystemicamyloidosis
AT ilhantezcan cvidassociatedwithsystemicamyloidosis