Common variable immunodeficiency (CVID). Signs of alert in infants

Common variable immunodeficiency (CVID) occurs less frequently in children than in adults. It is important to be able to make the diagnosis as early as possible in order to reduce the sequelae. In children, clinical manifestations at presentation are similar to those of adults. When bacterial infections are recurrent and resistant to treatment, determination of serum immunoglobulin levels should be done. The onset of an autoimmune disease or unexplained lymphoid infiltrations usually leads to a full immunological evaluation. Other complications such as lymphoma or failure to thrive are rarely revealing at presentation in children. The existence of a positive family history may allow an early diagnosis. Molecular screening is often impossible because genetic defects have not yet been identified for most cases of CVID. (C) 2009 Elsevier Masson SAS. All rights reserved.