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Allergic asthma in patients with common variable immunodeficiency

机译：常见可变免疫缺陷患者的过敏性哮喘

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Background: Many patients with common variable immunodeficiency (CVID) have a clinical history suggestive of allergic respiratory disease. However, in such individuals, the prevalence of asthma and the role of atopy have not been well established. The objective of this study was to evaluate pulmonary function and identify asthma in patients with CVID. We also investigated the role of IgE as a trigger of asthma in these patients.Methods: Sixty-two patients diagnosed with CVID underwent spirometry, as well as skin prick testing and in vitro determination of serum-specific IgE levels for aero-allergens, together with bronchial provocation with histamine and allergen. Results: The most common alteration identified through spirometry was obstructive lung disease, which was observed in 29 (47.5%) of the 62 patients evaluated. Eighteen (29.0%) of the 62 patients had a clinical history suggestive of allergic asthma. By the end of the study, asthma had been diagnosed in nine (14.5%) patients and atopy had been identified in six (9.7%). In addition, allergic asthma had been diagnosed in four patients (6.5% of the sample as a whole; 22.2% of the 18 patients with a clinical history suggestive of the diagnosis).Conclusion: In this study, CVID patients testing negative for specific IgE antibodies and suspected of having allergic asthma presented a positive response to bronchial provocation tests with allergens. To our knowledge, this is the first such study. When CVID patients with a history suggestive of allergic asthma test negative on traditional tests, additional tests designed to identify allergic asthma might be conducted.
机译：背景：许多具有共同可变免疫缺陷（CVID）的患者都有临床史，提示过敏性呼吸系统疾病。然而，在这类个体中，哮喘的患病率和特应性作用尚未得到很好的确定。这项研究的目的是评估CVID患者的肺功能并确定哮喘。我们还调查了这些患者中IgE引发哮喘的作用。方法：对62名诊断为CVID的患者进行了肺量计测定，皮肤点刺测试和体外测定气敏性血清特异性IgE水平。伴有组胺和过敏原的支气管刺激。结果：通过肺活量测定法确定的最常见的改变是阻塞性肺部疾病，在评估的62例患者中有29例（47.5％）观察到了这种改变。 62名患者中有18名（29.0％）的临床病史提示了过敏性哮喘。到研究结束时，已在9名（14.5％）患者中诊断出哮喘，在6名（9.7％）中发现了特应性。此外，已经确诊了4例过敏性哮喘（占整体样本的6.5％; 18例具有诊断病史的患者的22.2％）。结论：在本研究中，CVID患者的特异性IgE检测阴性抗体和怀疑患有过敏性哮喘的人，对过敏原的支气管激发试验呈阳性反应。就我们所知，这是第一个这样的研究。当具有变应性哮喘病史的CVID患者在传统检查中呈阴性时，可进行旨在鉴定变应性哮喘的其他检查。

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