Predictive Factors for and Complications of Bronchiectasis in Common Variable Immunodeficiency Disorders

Bronchiectasis is a frequent complication of common variable immunodeficiency disorders (CVID). In a cohort of patients with CVID, we sought to identify predictors of bronchiectasis. Secondly, we sought to describe the impact of bronchiectasis on lung function, infection risk, and quality of life. We conducted an observational cohort study of 110 patients with CVID and an available pulmonary computed tomography scan. The prevalence of bronchiectasis was 53%, with most of these patients (54%) having mild disease. Patients with bronchiectasis had lower median serum immunoglobulin (Ig) concentrations, especially long-term IgM (0 vs 0.25 g/l; p < 0.01) and pre-treatment IgG (1.3 vs 3.7 g/l; p < 0.01). CVID patients with bronchiectasis had worse forced expiratory volume in one second (2.10 vs 2.99 l; p < 0.01) and an annual decline in forced expiratory volume in one second of 25 ml/year (vs 8 ml/year in patients without bronchiectasis; p = 0.01). Patients with bronchiectasis also reported more annual respiratory tract infections (1.77 vs 1.25 infections/year, p = 0.04) and a poorer quality of life (26 vs 14 points in the St George’s Respiratory Questionnaire; p = 0.02). Low serum immunoglobulin M concentration identifies patients at risk for bronchiectasis in CVID and may play a role in pathogenesis. Bronchiectasis is relevant because it is associated with frequent respiratory tract infections, poorer lung function, a greater rate of lung function decline, and a lower quality of life.

Atopic dermatitis and its association with serum immunoglobulin E levels: our experience in KVG medical college and hospital, Karnataka

<p><strong>Background:</strong> Eczema is an inflammatory skin reaction which presents as acute, subacute and chronic forms. Eczemas persisting for more than 6 weeks or characterized by thickening and discoloration of skin is typical of chronic eczema. Atopic dermatitis (AD) is a type of chronic or chronically relapsing eczematous skin disorder. To determine the percentage of AD in all forms of chronic eczema by using HRC. We also estimated serum immunoglobulin E (IgE) levels and determined its correlation with chronic eczemas and with various clinical parameters of HRC.</p><p><strong>Methods:</strong> A total of 50 patients with chronic eczema meeting defined inclusion and exclusion criteria were enrolled in this cross-sectional study after taking an informed consent and approval of institutional ethical committee. All patients were subjected to a detailed history based on a questionnaire. A thorough clinical examination was done to determine all major and minor clinical parameters of HRC for AD. Blood samples were collected and AEC and total serum IgE levels were determined.</p><p><strong>Results:</strong> Most of our study patients were females (64%). Majority of males (77.7%) were farmers and majority of females (56.2%) were housewives assisting in fieldwork activities. Various causes of chronic eczema were clinically diagnosed AD (34%), chronic actinic dermatitis (8%), polymorphic light eruption (4%), airborne contact dermatitis (10%), phyto-photodermatitis (10%), chronic hand and/or foot eczema (16%) and seborrheic dermatitis (2%). Thirty-two patients (64%) satisfied HRC. Among all clinical parameters of HRC, pruritus and xerosis were the commonest in AD patients. Serum IgE level was raised in 58% of chronic eczema and 68.7% of AD patients.</p><p><strong>Conclusions:</strong> Serum IgE levels showed significant association with typical morphology and distribution of lesions, early age of onset and perifollicular accentuation.</p><h2> </h2>

Increased Total Serum Immunoglobulin E Is Likely to Cause Complications of Mycoplasma pneumoniae Pneumonia in Children

ObjectiveTo investigate the correlation between serum immunoglobulin E (IgE) levels and the complications in children with Mycoplasma pneumoniae pneumonia (MPP).MethodsA retrospective study of MPP patients hospitalized from May 2019 to July 2021 was performed. We analyzed the clinical manifestations, complications, laboratory findings, and treatments.ResultsA total of 275 patients who met the inclusion criteria were enrolled in the study. We divided patients into two groups based on whether there were complications. Complications occurred in 147 patients, of which pulmonary complications were more common than extrapulmonary complications. The IgE level in the complication group was higher than that in the non-complication group with p = 0.041. Patients with complications of necrotizing pneumonitis, pneumothorax, skin rash, or bronchiolitis obliterans had higher IgE levels. There was no statistically significant difference in IgE levels between pulmonary complications and extrapulmonary complications. The older the age, the greater the probability of complications (p = 0.001). The group with complications was more likely to have chest pain (p = 0.000), while the group without complications was more likely to have wheezing (p = 0.017). The use of bronchoscopy and glucocorticoids was higher in the complication group than in the non-complication group (p = 0.000).ConclusionsMPP patients with higher IgE levels had more severe clinical symptoms and complications. We speculated that IgE might be a biomarker for complications after MP infection.