Common Variable Immunodeficiency and Furunculosis
(Boil)
Title: A case of common variable immunodeficiency
presenting with furunculosis
Authors: 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.
