[Bronchiectasis severity in adult patients with common variable immunodeficiency]

BACKGROUND

Common variable immunodeficiency (CVID) is the most common primary symptomatic humoral immunodeficiency in adults. Antibody deficiency entails higher susceptibility to sinopulmonary infections and bronchiectasis formation, which is related to increased mortality. Scales have been established to assess the degree of severity of bronchiectasis in order to predict outcomes such as mortality, exacerbations and hospitalizations.

OBJECTIVE

To determine bronchiectasis severity in adult patients with common variable immunodeficiency using the Brief Symptom Inventory scale.

METHOD

Cross-sectional study in adult population diagnosed with common variable immunodeficiency and attended to at the Mexican Institute of Social Security National Medical Center Siglo XXI Specialty Hospital.

RESULTS

Bronchiectasis severity according to the Brief Symptom Inventory was mild in 60% of patients and moderate in 40%. Statistically significant differences were found for body mass index, number of affected lobes and type of bronchiectasis (p < 0.001).

CONCLUSIONS

Using bronchiectasis severity scales in patients with common variable immunodeficiency is indispensable for clinical and therapeutic decision making; however, determining the most appropriate instrument to assess bronchiectasis severity in this population is necessary.

[Epidemiological study on atopic dermatitis in Mexico]

BACKGROUND

There is limited epidemiological information on the treatment of atopic dermatitis (AD) from specialist physicians in Mexico.

OBJECTIVE

To know the criteria that is used by specialists in Mexico to diagnose and treat AD.

METHODS

An observational, descriptive and cross-sectional study, which was authorized by the ethics committee, was carried out through an electronic survey.

RESULTS

114 surveys were carried out; 56% of the participants were allergists, 38% were dermatologists and 5% were pediatricians. It was identified that 54% used clinical criteria for the diagnosis of AD and 42% used the criteria of Hanifin-Rajka as a diagnostic complement; 38% requested total and/or specific IgE, blood biometry and blood chemistry tests. They recount that 90% of patients under the age of 18 had mild AD, 8% had moderate AD and 2% had severe AD; and, in patients over the age of 18, 89% had mild AD, 6% had moderate AD and 5% had severe AD. The patients' care was multidisciplinary, since 57% of the survey respondents requested assessments combined with ophthalmology, dermatology and allergology.

CONCLUSION

Knowledge of the disease will lead to a better control of the disease. The challenge is to have a patient registry, update treatment guidelines, consider comorbidities and have therapeutic options for its control.

[Type and location of bronchiectasis in a cohort of adults with common variable immunodeficiency]

BACKGROUND

Bronchiectasis are permanent dilatations of the bronchi. Its prevalence in patients with variable common immunodeficiency (CVID) is high, however there is little information regarding the type and location of the same; therefore the objective of this study is to know the type and location of bronchiectasis in a cohort of adult patients with CVID.

METHODS

It has been made a transversal, observational and descriptive study that included 32 adult patients with diagnosis of CVID according to the criteria of the European Society of Immunodeficiencies (ESID). All patients underwent high resolution pulmonary computed tomography (HRCT), which were interpreted by an expert radiologist. The frequency, type and location of bronchiectasis were reported using descriptive statistics.

RESULTS

Thirty-two adult patients, ten men (31.25%) and 22 women (68.7%), were included. 40.6% had bronchiectasis. 23% had a lobe involvement, 15.3% two lobes, 46.1% 3 lobes and 15.3% complete involvement of the parenchyma. The types of bronchiectasis were distributed as follows: tubular 38.4%, varicose 23% and cystic and tubular combinations 15.3%, cystic and varicose 15.3% and cystic, tubular and varicose 7.6%.

CONCLUSIONS

Our results show that 40% of adult patients with CVID have BQs, usually affecting three pulmonary lobes, located mainly in the right and middle lower lobe; The tubular type, is the most common. Their timely diagnosis and treatment can improve survival and reduce costs for patients and health care.