Common Variable Immunodeficiency: Computed Tomography Evaluation of Bronchopulmonary Changes Including Nodular Lesions in 40 Patients. Correlation With Clinical and Immunological Data

Background: Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency characterized by recurrent respiratory tract infections, mainly sustained by encapsulated bacteria, that may cause irreversible changes in the lungs. Methods: Forty patients with CVID were evaluated by computed tomography of the lung; 20 of these underwent computed tomographic follow-up in a 5-year period, during which immunoglobulin replacement therapy was regularly performed. Results: Pulmonary changes were present in 65% of patients; bronchiectases were present in 65.38%. The incidence of pulmonary nodules was very high (38.46%) and correlated with splenomegaly (70%) and autoimmune phenomena (80%). Conclusions: Our study underscores the essential role of imaging, in particular computed tomography, in the identification and monitoring of pulmonary lesions in a large cohort of CVID patients, contributing at the same time to select patients more at risk to develop nodular lesions and potentially to use more appropriate therapeutic strategies.