| Background: Common variable immunodeficiency (CVID) is the most prevalent
symptomatic primary immunodeficiency disorder characterized by infectious and
noninfectious complications. Bronchiectasis continues to be a common respiratory
problem and therapeutic challenge in CVID. The aim of this study is to estimate the
overall prevalence of bronchiectasis and its associated phenotype in patients with
CVID.
Methods: A systematic literature search was performed in Web of Science,
PubMed, and Scopus from the earliest available date to February 2019 with
standard keywords. All pooled analyses of bronchiectasis prevalence and the
corresponding 95% confidence intervals (CIs) were based on random‐effects
models.
Results: Fifty‐five studies comprising 8535 patients with CVID were included in the
meta‐analysis. Overall prevalence of bronchiectasis was 34% (95% CI: 30‐38;
I2 = 90.19%). CVID patients with bronchiectasis had significantly lower serum
immunoglobulin A (IgA) and IgM levels at the time of diagnosis compared with those
without bronchiectasis. Among the clinical features, the frequencies of splenomegaly,
pneumonia, otitis media, and lymphocytic interstitial pneumonia were significantly higher in CVID patients with bronchiectasis compared with those without
bronchiectasis, respectively.
Conclusion: A higher prevalence of bronchiectasis in patients with CVID should be
managed by controlling recurrent and severe pneumonia episodes which are immune
dysregulation since this complication is associated with poor prognosis in these
patients. |