Khanbabaee Ghamartaj, Khazaii Fatemeh, Chavoshzadeh Zahra, Rekabi Mahsa, Ghomi Zahra, Zeinali Vahide, Pourghasem Matin, Soflaee Maedeh, Ghadrdan Mahsa
Department of Pediatric Pulmonology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Immunology and allergy, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Immunol. 2024 Jul 16;25(1):45. doi: 10.1186/s12865-024-00640-0.
Interstitial lung disease (ILD) is a prevalent complication in patients with common variable immunodeficiency (CVID) and is often related to other characteristics such as bronchiectasis and autoimmunity. Because the term ILD encompasses a variety of acute and chronic pulmonary conditions, diagnosis is usually based on imaging features. Histopathology is less available. This study was conducted with the aim of investigating the ILD in patients with CVID.
In this retrospective cross-sectional study, sixty CVID patients who referred to the pulmonology and immunodeficiency clinics of Mofid Children's Hospital between 2013 and 2022 were included. The diagnosis of ILD were based on transbronchial lung biopsy (TBB) or clinical and radiological symptoms. The prevalence of ILD in CVID patients was determined. Also, the CVID patients with and without ILD were compared in terms of demographic characteristics, clinical, laboratory and radiologic findings.
Among all patients, ten patients had ILD (16.6%). In terms of laboratory parameters, there was a significant difference between platelets in the two groups of CVID patients with and without ILD, and the level of platelets was higher in the group of patients with ILD. Moreover, in terms of clinical symptoms, pneumonia, diarrhea and hepatomegaly were significantly different between the two groups and were statistically higher in the group of patients with ILD (P < 0.05). Autoimmunity and malignancy were not significantly different in two groups. There was a significant difference in, hyperinflation between the two groups of CVID patients with and without ILD, and the frequency of, hyperinflation was higher in the patients without ILD (P = 0.040).
Understanding the pathogenesis of ILD plays an essential role in revealing non-infectious pulmonary complications that occur in CVID patients. Increasing efforts to understand ILD not only shed light on its hidden pathogenesis and clinical features, but also enhance our understanding of CVID in a broader sense.
间质性肺疾病(ILD)是常见可变免疫缺陷(CVID)患者中普遍存在的并发症,且常与支气管扩张和自身免疫等其他特征相关。由于术语ILD涵盖了各种急性和慢性肺部疾病,诊断通常基于影像学特征。组织病理学检查则较少采用。本研究旨在调查CVID患者中的ILD情况。
在这项回顾性横断面研究中,纳入了2013年至2022年间转诊至莫菲德儿童医院肺病科和免疫缺陷门诊的60例CVID患者。ILD的诊断基于经支气管肺活检(TBB)或临床及放射学症状。确定CVID患者中ILD的患病率。此外,对有ILD和无ILD的CVID患者在人口统计学特征、临床、实验室和放射学检查结果方面进行比较。
在所有患者中,有10例患者患有ILD(16.6%)。在实验室参数方面,有ILD和无ILD的两组CVID患者的血小板存在显著差异,ILD患者组的血小板水平更高。此外,在临床症状方面,两组之间的肺炎、腹泻和肝肿大存在显著差异,且在ILD患者组中在统计学上更高(P < 0.05)。两组之间的自身免疫和恶性肿瘤无显著差异。有ILD和无ILD的两组CVID患者之间的肺过度充气存在显著差异,无ILD患者的肺过度充气频率更高(P = 0.040)。
了解ILD的发病机制对于揭示CVID患者发生的非感染性肺部并发症起着至关重要的作用。加大对ILD的研究力度不仅有助于揭示其隐藏的发病机制和临床特征,还能从更广泛的意义上增进我们对CVID的理解。