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

Clin Immunol. 2019 Jun:203:59-62. doi: 10.1016/j.clim.2019.04.001. Epub 2019 Apr 17.

Abstract

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.

Keywords: CID; CVID; Combined immunodeficiency; Complications; Definition; Opportunistic infection; naïve CD4 T cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers
  • CD4-Positive T-Lymphocytes / immunology*
  • Cells, Cultured
  • Cohort Studies
  • Common Variable Immunodeficiency / diagnosis*
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Patient Selection
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severe Combined Immunodeficiency / diagnosis*
  • T-Lymphocyte Subsets / immunology*

Substances

  • Biomarkers