alergia - Asmáticos com imunodeficiencia comum variável devem realizar outros testes além de pesquisa de IgE específicas
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alergia

Asmáticos com imunodeficiencia comum variável devem realizar outros testes além de pesquisa de IgE específicas

22/04/2010

Sumário 

 

Pacientes com imunodeficiência comum variável e que apresentavam testes negativos para anticorpos IgE específicos e com suspeita de ter asma alérgica apresentaram resposta positiva aos testes de broncoprovocação com alérgenos. Quando pacientes com imunodeficiência comum variável com história sugestiva de asma alérgica apresentam resultados negativos aos testes tradicionais, testes adicionais devem ser utilizados para identificar asma alérgica.


 

ORIGINAL ARTICLE
Allergic asthma in patients with common variable immunodeficiency
R. C. Agondi, M. T. Barros, L. V. Rizzo, J. Kalil & P. Giavina-Bianchi
Department of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
Correspondence to Pedro Giavina-Bianchi, R. Prof. Artur Ramos 178 ap.211A Jd. América, São Paulo, SP, CEP:01454-010, Brazil
 

Edited by: Hans-Uwe Simon

Copyright Journal compilation © 2010 John Wiley & Sons A/S
KEYWORDS
allergens • asthma • bronchial provocation tests • common variable immunodeficiency • immunoglobulin E

To cite this article: Agondi RC, Barros MT, Rizzo LV, Kalil J, Giavina-Bianchi P. Allergic asthma in patients with common variable immunodeficiency. Allergy 2010; 65: 510–515.

ABSTRACT

Background: Many patients with common variable immunodeficiency (CVID) have a clinical history suggestive of allergic respiratory disease. However, in such individuals, the prevalence of asthma and the role of atopy have not been well established. The objective of this study was to evaluate pulmonary function and identify asthma in patients with CVID. We also investigated the role of IgE as a trigger of asthma in these patients.

Methods: Sixty-two patients diagnosed with CVID underwent spirometry, as well as skin prick testing and in vitro determination of serum-specific IgE levels for aeroallergens, together with bronchial provocation with histamine and allergen.

Results: The most common alteration identified through spirometry was obstructive lung disease, which was observed in 29 (47.5%) of the 62 patients evaluated. Eighteen (29.0%) of the 62 patients had a clinical history suggestive of allergic asthma. By the end of the study, asthma had been diagnosed in nine (14.5%) patients and atopy had been identified in six (9.7%). In addition, allergic asthma had been diagnosed in four patients (6.5% of the sample as a whole; 22.2% of the 18 patients with a clinical history suggestive of the diagnosis).

Conclusion: In this study, CVID patients testing negative for specific IgE antibodies and suspected of having allergic asthma presented a positive response to bronchial provocation tests with allergens. To our knowledge, this is the first such study. When CVID patients with a history suggestive of allergic asthma test negative on traditional tests, additional tests designed to identify allergic asthma might be conducted.


Allergic asthma in patients with common variable immunodeficiency - Allergy; 2010;65:510-515

 

 



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