Common variable immunodeficiency (CVID) is not a single condition but covers, as the name implies, a variable group of disorders that all relate to a primary immune defect, resulting in impaired immunoglobulin (antibody) production. It has an incidence of about 1:50,000 with an equal sex ratio. Unlike the more svere combined immunodefieciency (SCID) which is diagnosed in infancy, the majority of patients with CVID are diagnosed between 10 and 40 years of age, with about 20 per cent diagnosed in childhood.
There is a probable genetic basis for most of the CVID disorders, although other factors are likely to be implicated in the clinical manifestations. The main problem is the individual's inability to produce adequate levels of immunoglobulins (antibodies), primarily IgG and IgA, although IgM can also be affected in some people. As a result of this, these people are prone to frequent and recurrent infections, particularly bacterial, involving the respiratory tract, ears and sinuses, as well as the gastrointestinal tract.
Therefore, a child who is prone to frequent infections, especially bacterial, involving the ears and chest, requiring muliple courses of antibiotics, should be referred to an immunologist for assessment of possible CVID. The relatively late diagnosis in adulthood would indicate that a relatively high percentage of these people are not having investigations done for this disorder. This may also result in a genetic predisposition being missed.
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