Non-infectious Pulmonary Complications in Children with Primary Immunodeficiency

Wimwipa Mongkonsritragoon, Ruma Srivastava, Divya Seth, Aishwarya Navalpakam, Pavadee Poowuttikul, Wimwipa Mongkonsritragoon, Ruma Srivastava, Divya Seth, Aishwarya Navalpakam, Pavadee Poowuttikul

Abstract

Primary immune deficiency (PID) is a large group of diseases characterized by defective immune function, leading to recurrent infections, and immune dysregulation. Clinical presentations, severity, and complications differ for each disease, based on the components of the immune system that are impacted. When patients with PID present with respiratory symptoms, infections should be initially suspected, investigated, and promptly managed. However, non-infectious complications of PID also frequently occur and can lead to significant morbidity and mortality. They can involve both the upper and lower respiratory systems, resulting in various presentations that mimic infectious diseases. Thus, clinicians should be able to detect these conditions and make an appropriate referral to an immunologist and a pulmonologist for further management. In this article, we use case-based scenarios to review the differential diagnosis, investigation, and multidisciplinary treatment of non-infectious pulmonary complications in patients with primary immune deficiencies.

Keywords: Pulmonary complications; agammaglobulinemia; chronic granulomatous disease; common variable immune deficiency; primary immune deficiency.

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2023.

Figures

Figure 1.
Figure 1.
HRCT of the patient with GLILD prior to starting treatment, showing a lung nodule (black arrow) and septal thickening (black arrowhead).
Figure 2.
Figure 2.
HRCT of the patient with scattered granuloma at lung bases (black arrow).

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