The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Granulomatous Disease in Common Variable Immunodeficiency

Laura J. Mechanic, MD; Steven Dikman, MD; and Charlotte Cunnigham-Rundles, MD, PhD
[+] Article, Author, and Disclosure Information

From Mount Sinai Medical Center, New York, New York, Acknowledgments: The authors thank Drs. Bruce DeCottis, Barbara Chilmonczyk, Frank Church, Richard Daniels, Jerry Winklestein, Howard Lederman, Jeffrey Lobel, Alvin Tierstein, Kirk Sperber, Lloyd Mayer, and Scott Hennigan for referral of patients; Dr. Carol Bodian for statistical analyses; and Lydia Lopez for secretarial assistance. Grant Support: In part by grant CA 533H from the National Cancer Institute, grant NIH 5 M01-RR-0071 from the National Center for Research Resources for the Mount Sinai General Research Center, and grant FD-R-001162-01 from the Office of Orphan Products Development. Requests for Reprints: Charlotte Cunningham-Rundles, MD, PhD, Division of Clinical Immunology, Mount Sinai School Medical Center, 1452 Madison Avenue, New York, NY 10029. Current Author Addresses: Drs. Mechanic and Cunningham-Rundles: Division of Clinical Immunology, Mount Sinai School of Medicine, 1452 Madison Avenue, New York, NY 10029. Dr. Dikman: Division of Clinical Pathology, Mount Sinai School of Medicine, 1452 Madison Avenue, New York, NY 10029.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(8_Part_1):613-617. doi:10.7326/0003-4819-127-8_Part_1-199710150-00005
Text Size: A A A

Background: Granulomatous lesions are occasionally found in the lymphoid or solid organs of patients with common variable immunodeficiency.

Objective: To examine the clinical and immunologic conditions in patients with common variable immunodeficiency who have granulomas.

Design: Case series.

Setting: Large tertiary care medical center.

Patients: 17 hypogammaglobulinemic patients with common variable immunodeficiency whose organ or tissue biopsy samples contained noncaseating granulomas.

Measurements: Results of lymphocyte function tests.

Results: Eight of 17 patients had granulomas at some point before hypogammaglobulinemia was diagnosed. Sixteen of the 17 had deficient T-cell proliferation to mitogens. Although 14 patients received standard treatment with intravenous immunoglobulin, they have had substantial illness, including frequent autoimmune disease.

Conclusions: Dysregulated T-cell function or macrophage activation may have been involved in formation of granulomas and increased illness in hypogammaglobulinemic patients with common variable immunodeficiency. Delay in recognition of antibody deficiency may have contributed to the severity of illness in these patients.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.