A Case Of Common Variable Immunodeficiency with Fatal Measles

ABSTRACT

Common variable immunodeficiency(CVID) is a heterogeneous immunodeficiency syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections, and a variety of immunological abnormalities. We report a 10-year-old boy diagnosed with CVID and a fatal case of measles. He was admitted for fever, cough, conjunctival injection with purulent discharge and maculopapular rash with some scattered pinpoint sized petechial lesions on the whole body for a duration of 5 days. Laboratory findings showed hypogammaglobulinemia [IgG 617 mg/dL(639-1,349 mg/dL), IgA 8.5 mg/dL(70-312 mg/dL), IgM 34.1 mg/dL(56-352 mg/dL)] and anti-measles antibody and anti HIV antibody were negative. He was treated with intravenous immunoglobulin 700 mg/kg on admission. Radiologic findings progressed from hyperaeration to fluffy margined interstitial and alveolar infiltrations on both lung fields. In spite of supportive and ventilator therapy, his pneumonia progressed to acute respiratory distress syndrome and he expired.