An unusual case of sinusitis.
BACKGROUND
Common Variable Immunodeficiency (CVID) is the commonest form of severe antibody deficiency. It is characterized by reduced levels of IgG (<400 mg/dL) and low IgA and/or IgM levels, recurrent bacterial infections, impaired antibody responses despite the presence of B Cells and normal or near normal T immunity in 60% of patients. There is a high mortality from infections without treatment. The main stay treatment is to replace the immunoglobulins.


METHODS
We describe a British soldier with a 10 year history of recurrent chest infections, sinusitis and otitis media. He repeatedly presented 2 to 3 times a year complaining of either a green nasal discharge or a cough productive of yellow/green sputum. He presented three years ago with severe sinusitis which resulted in investigations highlighting hypogammaglobulinaemia. Subsequently he was started on immunoglobulin therapy with Flebogamma 40 g three weekly.


CONCLUSIONS
Despite being a relatively rare condition, CVID when diagnosed, can be easily treated and improve patients' prognosis. Medical Officers should be aware of the condition as a differential diagnosis for individuals presenting with recurrent infections.
Lamb
L
L
Chelsea and Westminister Hospital, 369 Fulham Road, London, SW10 9NH. lucybaker45@hotmail.com
Richards
P
P
Edgar
J D M
JD
D000328:Adult; D001991:Bronchitis / Q000276:immunology; D017074:Common Variable Immunodeficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008889:Military Personnel; D010033:Otitis Media / Q000276:immunology; D012852:Sinusitis / Q000276:immunology*
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors