title: Lung disease in primary antibody deficiency.
abstract: This Review summarises current knowledge on the pulmonary manifestations of primary antibody deficiency (PAD) syndromes in adults. We describe the major PAD syndromes, with a particular focus on common variable immunodeficiency (CVID). Respiratory infection is a common presenting feature of PAD syndromes. Respiratory complications are frequent and responsible for much of the morbidity and mortality associated with these syndromes. Respiratory complications include acute infections, the sequelae of infection (eg, bronchiectasis), non-infectious immune-mediated manifestations (notably the development of granulomatous-lymphocytic interstitial lung disease in CVID), and an increased risk of lymphoma. Although minor abnormalities are detectable in the lungs of most patients with CVID by CT scanning, not all patients develop lung complications. Mechanisms associated with the maintenance of lung health versus lung disease, and the development of bronchiectasis versus immune-mediated complications, are now being dissected. We review the investigation, treatment, and management strategies for PAD syndromes, and include key research questions relating to both infectious and non-infectious complications of PAD in the lung.
authors.affiliation: Department of Immunology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Nisha
authors.initials: N
authors.lastname: Verma
authors.affiliation: Department of Immunology, Royal Free London NHS Foundation Trust, London, UK; Centre for Chronic Immunodeficiency, Medical Centre, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Bodo
authors.initials: B
authors.lastname: Grimbacher
authors.affiliation: UCL Respiratory, University College London, London, UK. Electronic address: j.hurst@ucl.ac.uk.
authors.forename: John R
authors.initials: JR
authors.lastname: Hurst
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000276:immunology*; D017074:Common Variable Immunodeficiency / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000276:immunology*; D012141:Respiratory Tract Infections / Q000276:immunology; D012307:Risk Factors