CT = computed tomography, CVID = common variable immunodeficiency, IgA = immunoglobulin A, IgG = immunoglobulin G, IgM = immunoglobulin M, LFT = liver function test, PFT = pulmonary function testing
It is recommended that patients with Common Variable Immunodeficiency have baseline response to multiple vaccines as well as evaluation of B cell subsets at the time of diagnosis. B cell subsets are recommended in the initial lab testing due to recent publications indicating their value in predicting future clinical course.³ Spirometry or a CT scan of the chest, IgG level, liver function tests, and creatinine levels are recommended as yearly follow-up testing. These guidelines are based on expert panel recommendations formulated through the Immune Deficiency Foundation as well as published recommendations of experts in the field.¹,²
Percentages of patients who received these tests are shown in the bars. B cell subset testing fell to 85% of patients, PFTs or CT to 80%, and IgG treatment to 91%, a reflection of the effects of the coronovirus pandemic.
¹ Immune Deficiency Foundation Diagnostic & Clinical Care Guidelines for Primary Immunodeficiency Diseases. Buckley et al. IDF Foundation 2009
² How I treat common variable immune deficiency. Cunningham-Rundles Blood. 2010 Jul 8;116(1):7-15. Carsetti R, Rosado MM, Donnanno S, et al.
³ The loss of IgM memory B cells correlates with clinical disease in common variable immunodeficiency. J Allergy Clin Immunol. 2005;115(2):412-417.