title: Can patients with common variable immunodeficiency have allergic rhinitis?
abstract: BACKGROUND
  Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID.
  
  
  METHODS
  This study included 72 adult CVID patients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro).
  
  
  RESULTS
  The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients.
  
  
  CONCLUSIONS
  In CVID patients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVID patients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVID patients would be nasal provocation with the most prevalent allergens.
authors.affiliation: Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil. ragondi@gmail.com
authors.forename: Rosana C
authors.initials: RC
authors.lastname: Agondi
authors.forename: Myrthes T
authors.initials: MT
authors.lastname: Barros
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Kokron
authors.forename: Andrea
authors.initials: A
authors.lastname: Cohon
authors.forename: Ana K B
authors.initials: AK
authors.lastname: Oliveira
authors.forename: Jorge
authors.initials: J
authors.lastname: Kalil
authors.forename: Pedro
authors.initials: P
authors.lastname: Giavina-Bianchi
mesh_terms: D000328:Adult; D017668:Age of Onset; D000485:Allergens / Q000276:immunology*; D017074:Common Variable Immunodeficiency / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D000939:Epitopes / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D000939:Epitopes; D007073:Immunoglobulin E