Common Variable Immunodeficiency and Furunculosis (Boil)

Title: A case of common variable immunodeficiency presenting with furunculosis
: Sidwell RU, et al.
Publication: Br J Dermatol. 2002 Aug;147(2):364-7.

Common variable immunodeficiency (CVID) is a common type of immunodeficiency or inability to develop a normal immune response. This condition is characterized by low IgG and IgA, and sometimes IgM levels.

There is some evidence of genetic susceptibility, as 20% of patients have inherited this condition in a dominant pattern (i.e. receiving 1 genetic copy from either the father or mother will suffice to cause the condition). People with CVID often have different symptoms and manifestation, which made it proper diagnosis difficult. Indeed, this condition is often not properly diagnosed until the patients are in their twenties or thirties, and often with irreversible organ damage (particularly bronchiectasis or dilation of the bronchial tube in the lungs). The exact mechanism of this immunodeficiency has not yet been understood.

The majority of patients have recurring infection of the nasal sinuses and airways to the lung. CVID, however, can also come in many different forms, such as:

  • gastrointestinal problems
  • granulomatous inflammation
  • skin disorders
  • enteroviral (a group of virus) and mycoplasma bacteria infections
  • auto-immune disorders (a condition where the person’s immune system mistakenly attacks its own body)
  • predisposition to lymphoma (cancer of the lymph nodes) and stomach cancer

The authors described a case of CVID which was identified when the patients developed widespread skin infection, fever, and malaise (general feeling of bodily discomfort).

The authors noted that this particular case is an important example of the various forms of CVID, and demonstrate the need for doctors to remain aware and vigilant when making clinical diagnosis.

Editor’s Note: IgG, IgA, and IgM refer to immunoglobulin G, A, and M, respectively. Immunoglobulins are large glycoproteins that are secreted by plasma cells and function as antibodies in the immune response by binding to specific antigens (foreign body or substance).

Granulomatous inflammation affects the granulation tissue, or new connective tissue and tiny blood vessels that form on the surface of healing wounds.

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