Spirometry and chest CT scan in diagnosing pulmonary complications in patients with primary humoral immunodeficiency at Imam Khomeini Hospital Immunology Clinic (2022-2023).

BACKGROUND

Primary immunodeficiency (PID), particularly B-cell immunodeficiency (BCID), is associated with recurrent infections and significant pulmonary complications. Early and effective diagnostic tools are critical for improving clinical outcomes in these patients.

OBJECTIVE

This study evaluates the effectiveness of spirometry compared to chest CT scans for diagnosing and monitoring pulmonary complications in BCID patients.

METHODS

A case series of 53 BCID patients, predominantly with Common Variable Immunodeficiency CVID, was conducted at Imam Khomeini Hospital (2022-2023). Spirometry patterns, including FEV1, FVC, FEV1/FVC ratios, and FEF25-75, were analyzed alongside CT findings, including air-trapping scores, bronchiectasis, and small airway disease. Statistical analyses included regression models to correlate spirometry and CT results.

RESULTS

Spirometry identified obstructive (49 %), normal (41.5 %), restrictive (7.5 %), and mixed patterns (2 %). CT scans revealed bronchiectasis (32 %), small airway disease, and ground-glass opacities. A significant correlation was observed between air-trapping scores and spirometry parameters (FEF25-75 and FEV1/FVC). Longitudinal assessments demonstrated a progressive increase in air-trapping scores, emphasizing the chronic nature of small airway involvement.

CONCLUSION

Spirometry offers a safer, cost-effective alternative to CT scans for early detection and monitoring of pulmonary complications in BCID patients. The strong concordance between spirometry results and CT findings supports its routine clinical use, minimizing radiation exposure and facilitating timely interventions.