Evaluating laboratory criteria for combined immunodeficiency in adult patients diagnosed with common variable immunodeficiency.

Authors:
Claudia Wehr
Claudia Wehr
Division of Rheumatology and Clinical Immunology
Germany
Sigune Goldacker
Sigune Goldacker
University Medical Center Freiburg
Germany
Gerhard Kindle
Gerhard Kindle
Universitätsklinik Freiburg
Germany
Alla Bulashevska
Alla Bulashevska
German Cancer Research Center
Michele Proietti
Michele Proietti
Institute for Research in Biomedicine
Italy
Bodo Grimbacher
Bodo Grimbacher
Center for Chronic Immunodeficiency
Germany

Clin Immunol 2019 Jun 17;203:59-62. Epub 2019 Apr 17.

Department for Rheumatology and Clinical Immunology and Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. Electronic address:

Some patients diagnosed with common variable immunodeficiency (CVID) actually suffer from combined immunodeficiency (CID) and therefore may require a different, CID-adapted treatment. Several CD4 T-cell-based criteria have been proposed in the past to identify patients with CID within the cohort of adult CVID patients. In this monocentric study, we used retrospective immunological and clinical data of 238 CVID patients to compare four different proposals of how to define CID among CVID patients. We demonstrate that none of the current definitions sufficiently separates CID from CVID patients and that the relative reduction of naïve CD4 T cells <10% has the highest sensitivity of all tested markers for patients with clinical complications often associated with CID. Thus, a very low percentage of naïve CD4 T cells in any adult CVID patient should raise suspicion, but is not sufficient to define CID among CVID patients.

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Source
http://dx.doi.org/10.1016/j.clim.2019.04.001DOI Listing
June 2019
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