title: [Hematopoietic stem cells transplant in patients with common variable immunodeficiency. Is a therapeutic option?]
abstract: Patients with common variable immunodeficiency show higher incidence of sinopulmonary and gastrointestinal infections, as well as lymphoproliferative and autoimmune diseases. The treatment of choice is replacement therapy with human gamma-globulin. Hematopoietic stem cell transplantation is a non-conventional therapeutic modality.
  
  
  
  Twenty-six-year old woman with no family or hereditary history of primary immune deficiencies or consanguinity, with repeated episodes of otitis, sinusitis, gastroenteritis and bronchitis since childhood. At adolescence, she was diagnosed with common variable immunodeficiency; she was prescribed intravenous gamma-globulin, broad-spectrum antimicrobials and macrolides. At 22 years of age, she underwent hematopoietic stem cell transplantation owing to continued severe infections. At 4 months, post-transplantation she was diagnosed with hypothyroidism and ovarian insufficiency. During the following 3 years, she had no infections, but at 25 years of age she had immune thrombocytopenic purpura diagnosed, which persists together with Raynaud's disease and upper respiratory tract persistent infections. At the moment of this report she is being treated with intravenous gamma-globulin and receiving prophylaxis with clarithromycin, without steroids or danazol.
  
  
  
  Given the high rate of morbidity and mortality associated and immune reconstitution failure, hematopoietic stem cell transplantation should be carefully evaluated in patients with treatment-unresponsive infections or lymphoproliferative disorders.
authors.affiliation: Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Servicio de Alergia e Inmunología Clínica. Ciudad de México, México. jcesar_963@hotmail.com.
authors.forename: Julio César
authors.initials: JC
authors.lastname: Cambray-Gutiérrez
authors.forename: Diana Andrea
authors.initials: DA
authors.lastname: Herrera-Sánchez
authors.forename: Patricia
authors.initials: P
authors.lastname: López-Pérez
authors.forename: Aurora
authors.initials: A
authors.lastname: Chávez-García
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Yamazaki-Nakashimada
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001987:Bronchiectasis / Q000209:etiology; D003131:Combined Modality Therapy; D017074:Common Variable Immunodeficiency / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D050031:Hashimoto Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology; D011928:Raynaud Disease / Q000209:etiology; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000209:etiology; D013967:Thyroiditis, Autoimmune / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D016756:Immunoglobulins, Intravenous
keywords: Common variable immunodeficiency; Hematopoietic progenitor cell transplant; Human gamma globulin