Intravenous Immunoglobulin Monotherapy for Granulomatous Lymphocytic Interstitial Lung Disease in Common Variable Immunodeficiency

Intern Med. 2017 Nov 1;56(21):2899-2902. doi: 10.2169/internalmedicine.7757-16. Epub 2017 Sep 15.

Abstract

Common variable immunodeficiency (CVID) is a heterogeneous subset of immunodeficiency disorders. Recurrent bacterial infection is the main feature of CVID, but various non-infectious complications can occur. A 42-year-old woman presented with cough and abnormal chest X-ray shadows. Laboratory tests showed remarkable hypogammaglobulinemia. Computed tomography revealed multiple consolidation and nodules on the bilateral lung fields, systemic lymphadenopathy, and splenomegaly. A surgical lung biopsy specimen provided the final diagnosis of lymphoproliferative disease in CVID, which was grouped under the term granulomatous lymphocytic interstitial lung disease. Interestingly, the lung lesions of this case resolved immediately after the initiation of intravenous immunoglobulin monotherapy.

Keywords: common variable immunodeficiency; granulomatous lymphocytic interstitial lung disease; hypogammaglobulinemia; intravenous immunoglobulin therapy; lymphoproliferative disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Common Variable Immunodeficiency / complications
  • Common Variable Immunodeficiency / diagnosis
  • Common Variable Immunodeficiency / drug therapy*
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Lung / pathology
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / diet therapy*
  • Tomography, X-Ray Computed / methods

Substances

  • Immunoglobulins, Intravenous