[Respiratory manifestations of common variable immunodeficiency in adults].

INTRODUCTION: Sporadic common variable immunodeficiency (CVID) is the most frequent cause of primary humoral immunodeficiency observed in adults. Respiratory complications occur frequently.

STATE OF ART: Recurrent bacterial pneumonia and bronchial suppuration are the most frequent complications whilst reactive interstitial pneumonitis (lymphoid interstitial pneumonia and sarcoid-like granulomatosis) and pulmonary lymphoma involvement are rarer. Treatment is based on replacement infusions of gamma globulin (Ig-IV). Although treatment has been shown to reduce the frequency of pulmonary infections, respiratory complications are still responsible for one third of late mortality in CVID.

PERSPECTIVES: Type and frequency of respiratory survey has to be defined, as well as the indication for other treatments than Ig-IV.

CONCLUSIONS: Protein electrophoresis must be done in a young adult with recurrent low respiratory tract infections and/or diffuse bronchectasis. Hypogammaglobulinemia should result in immunological and hematological investigations which may help to the diagnosis of CVID and to the beginning of the adequate treatment.