title: Pulmonary complications in primary hypogammaglobulinemia: a survey by high resolution CT scan.
abstract: BACKGROUND
  Primary hypogammaglobulinemia disorders are a group of heterogeneous immunodeficiency syndromes with an increased susceptibility to pulmonary complications.
  
  
  METHODS
  The aim of this study was to evaluate the extent of lung abnormalities in primary hypogammaglobulinaemic patients by high resolution computed tomography (HRCT) scan and pulmonary function test (PFT). HRCT and PFT were performed in 22 Iranian patients with primary hypogammaglobulinemia.
  
  
  RESULTS
  Pathological bronchial findings were observed in thirteen patients: three patients showed only peribronchial thickening and the remaining ten patients suffered from both bronchiectasis and peribronchial wall thickening. Mild type of bronchiectasis and peribronchial wall thickening were the most common type, predominantly observed in the right middle and both right and left lower lobe segments of lungs. Although bullae were not found, emphysema, air-trapping, and collapse/consolidation were observed in two patients. Bronchial involvement was mostly limited to 1 up to 5 bronchopulmonary segments; only one HRCT indicated bronchial involvement in more than nine bronchopulmonary segments. Pathological bronchial findings mostly observed in the proximal bronchi; meanwhile the involvement of the distal bronchi was less common. Decreasing FEVI and FVC were observed in 65% and 55% of patients, respectively. There was a significant correlation between the HRCT score and the predicted values by PFT. The delay of diagnosis in patients with bronchiectasis was significantly higher than those without bronchiectasis.
  
  
  CONCLUSIONS
  It seems that the majority of hypogammaglobulinaemic patients suffer from the mild type of bronchiectasis, which is mostly observed in the proximal bronchi of the lower lobe segments. The delay of diagnosis plays an important role in the occurrence of this complication in these patients.
authors.affiliation: Department of Allergy and Clinical Immunology, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran. gharagoz@tums.ac.ir
authors.forename: M
authors.initials: M
authors.lastname: Gharagozlou
authors.forename: F A
authors.initials: FA
authors.lastname: Ebrahimi
authors.forename: A
authors.initials: A
authors.lastname: Farhoudi
authors.forename: A
authors.initials: A
authors.lastname: Aghamohammadi
authors.forename: M-H
authors.initials: MH
authors.lastname: Bemanian
authors.forename: Z
authors.initials: Z
authors.lastname: Chavoshzadeh
authors.forename: M
authors.initials: M
authors.lastname: Heidarzadeh
authors.forename: M
authors.initials: M
authors.lastname: Mehdizadeh
authors.forename: M
authors.initials: M
authors.lastname: Moin
authors.forename: M
authors.initials: M
authors.lastname: Movahedi
authors.forename: M
authors.initials: M
authors.lastname: Nabavi
authors.forename: Z
authors.initials: Z
authors.lastname: Pourpak
authors.forename: N
authors.initials: N
authors.lastname: Rezaei
mesh_terms: D000293:Adolescent; D000361:Agammaglobulinemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D012044:Regression Analysis; D012129:Respiratory Function Tests / Q000379:methods; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods