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Are respiratory infections related to immunological and genetic data in common variable immunodeficiency, IgG subclass deficiency and IgA deficiency?

Abstract number: R2364

Mateu L., Pedro-Botet M.L., Herrero M.J., Ruiz E., Garcia Olivé I., Rey-Joly C., Sabrià M.

Background: Patients with common variable immunodeficiency (CVID), IgG subclass deficiency and IgA deficiency have clinical heterogeneity not always related to immunoglobulin concentrations. Few studies have evaluated the relationship between immunological data and respiratory tract infections. Genetic or immunological markers combined with IgG concentrations may be useful to establish the prognosis and treatment of these patients. We describe clinical, immunological and genetic variables in patients with CVID, IgG subclass deficiency and IgA deficiency and evaluate whether the number of IgM memory B and dendritic cells and TACI mutations justify the clinical heterogeneity.

Methods: Prospective observational study of patients with CVID, IgG subclass and IgA deficiency from 1989–2008 with descriptive analysis of clinical, immunological and genetic variables. Two groups were made according to clinical manifestations: Group 1 with high illness burden; Group 2 with low illness burden. We compared IgG concentrations, IgM memory B and dendritic cell count and TACI mutations in both groups with Fisher statistics.

Results: 20/29 patients were evaluated: 9 CVID, 9 IgG subclassdeficiency, 2 IgA deficiency. Recurrent lung infections (85%) were the most common manifestation. 9 (45%) patients were included in group 1. The rate of B memory IgM cells <15% and dendritic cell count <5 cells/mL were significantly more frequent in group 1. Mutations encoding for TACI were only detected in Group 1. The sensitivity and specificity of at least 1/3 positive tests to detect patients with high illness burden were 100% and 90.9%, respectively. There was no significant correlation between IgG < 500 mg/dL and illness burden.

Conclusions: Immunological and genetic variables allow better characterization of CVID, IgG subclass and IgA deficiency. IgG concentration alone is not sufficient to predict patient outcome.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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