New diagnosis of common variable immunodeficiency in a 12-year-old with pneumonia: an illustrative case

Focus on Chronic Variable Immunodeficiency for Primary Care Practitioners, the Gatekeepers to Optimal Health Outcomes for Primary Immunodeficiency Syndromes

Purpose of Review

This review sought to assess the extent and causes of suboptimal healthcare outcomes for chronic variable immunodeficiency (CVID).

Recent Findings

Significant improvements in diagnostic technology and treatment protocols over time were found, leading to reduced morbidity and mortality for those accessing therapies. Treatments continue to be largely non-curative with financing (mainly insurance coverage) an obstacle. Symptom recognition by primary care practitioners (PCP) remains a gating factor to treatment and a widespread and persistent barrier to optimal health outcomes.

Summary

CVID is a subtype of primary immunodeficiency (PIDD) associated with under-diagnosis. It has emerged as a health issue more prevalent than historically known. No symptom-recognition framework for early detection of CVID has been generally accepted; those proposed for primary immunodeficiencies have shown low sensitivity, low specificity or both. Positive trends in cases diagnosed have been aided by awareness campaigns and international collaborations. However, treatments for CVID will not realize full potential without effective, accepted frameworks for timely identification in the clinic.