Background:
Children with common
variable
immunodeficiency (CVID)
have increased
susceptibility to
infections.
Objective: We
evaluated the role
of intravenous
immunoglobulin (IVIG)
replacement therapy
on the clinical
outcome of patients
with CVID.
Methods: We
studied children
diagnosed with CVID
and treated with
IVIG (500 mg/kg
every 3 weeks).
Results: The
study population
comprised 29
children with CVID
(mean [SD] age, 11.8
[6.1] years) with at
least 1 year of
follow-up before
IVIG replacement
therapy. Mean
follow-up duration
was 5.6 (3.5) years
(range, 15 months-14
years). During
therapy, median
serum Ig levels
increased from 410
to 900 mg/dL. The
mean number of
respiratory
infections per
patient per year
decreased
significantly from
10.2 to 2.5. The
annual number and
length of hospital
stays decreased
significantly from
1.36 to 0.21 and
16.35 to 6.33 days
per patient,
respectively. The
mean annual number
of antibiotics used
decreased
significantly from
8.27 to 2.50 per
patient. Twelve
patients had
developed
bronchiectasis
before initiation of
IVIG; 3 patients
were cured of this
condition. Age at
diagnosis,
diagnostic delay,
number of
respiratory tract
infections, and
number of
antibiotics were
found to be signifi
cantly higher in
patients with
bronchiectasis, as
was lower B-cell
percentage. However,
gastrointestinal
involvement due to
noninfectious causes
did not improve
signifi cantly after
IVIG replacement
therapy.
Conclusion:
CVID patients
treated with IVIG
(500 mg/kg every 3
weeks) had
satisfactory serum
IgG levels, fewer
respiratory tract
infections, fewer
and shorter hospital
stays, and reduced
antibiotic usage.
However, no effect
on gastrointestinal
involvement was
observed. Early IVIG
replacement therapy
is important in
preventing
bronchiectasis.
Key words:
Common variable
immunodeficiency.
Intravenous
immunoglobulin.
Children.
|