成人普通变异型免疫缺陷病1例报道并文献复习

钟海媚; 凌华湘; 黄立霞; 王红燕

doi:10.16766/j.cnki.issn.1674-4152.003357

成人普通变异型免疫缺陷病1例报道并文献复习

doi: 10.16766/j.cnki.issn.1674-4152.003357

1.
华中科技大学协和深圳医院全科医学科，广东深圳 518052
2.
暨南大学第二临床医学院，广东深圳 518020
3.
华中科技大学协和深圳医院呼吸与危重症医学科
4.
华中科技大学协和深圳医院感染科

基金项目:

广东省医学科学技术研究基金项目 A2022497

详细信息

通讯作者:
王红燕，E-mail: doctorwanghongyan@163.com

中图分类号: R593.3
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- 文章访问数: 187
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- PDF下载量: 24
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-11
- 网络出版日期: 2024-03-09

Adult common variable immunodeficiency: a case report and literature review

1.
Department of General Practice, Union Shenzhen Hospital of Huazhong University of Science and Technology, Shenzhen, Guangdong 518052, China

摘要

摘要: 本文报道1例成人普通变异型免疫缺陷病(CVID)，患者男性, 38岁，发病前身体素质良好，10年前开始因反复发生肺部及其他部位感染多次住院，此次因“肺部感染”再次入院，入院查免疫球蛋白普遍低下，排除其他引起免疫球蛋白低下的可能原因后考虑诊断CVID，予积极静脉补充免疫球蛋白、抗感染等治疗后症状缓解，但予静脉输入丙种球蛋白后复查免疫球蛋白并无明显提高，建议患者出院后长期规律补充丙种球蛋白后复查。
- 普通可变性免疫缺陷 /
- 疾病特征 /
- 免疫
Abstract: This paper reports a case of adult common variable immunodeficiency (CVID). The patient was a 38-year old man who had been in good health prior to the onset of the disease and had been hospitalized several times over the previous 10 years for pulmonary and other infections. This time, the patient was hospitalized again for a lung infection and was found to have low immunoglobulin levels. After excluding other possible causes of low immunoglobulin, the patient was diagnosed with CVID. The symptoms improved after intravenous immunoglobulin, anti-infective and other treatments. However, there was no significant improvement in immunoglobulin. It is suggested that the patient should be regularly supplemented with intravenous immunoglobulin for a long time after discharge. The relevant literature was also reviewed in this paper.
- Common variable immunodeficiency /
- Disease characteristics /
- Immunity

HTML全文

图 1 支气管镜下活检肺组织病理(HE染色，×80)

Figure 1. Pathology section of lung tissue form the bronchoscopic biopsy (HE staining, ×80)

下载: 全尺寸图片幻灯片

表 1 患者外周血及肺泡灌洗液淋巴细胞亚群比值

Table 1. Lymphocyte subsets ratio in peripheral blood and alveolar lavage fluid

项目名称	检测结果	参考范围
外周血
CD3⁺(%)	89.70	61.00~85.00
CD3⁺CD4⁺(%)	19.00	28.00~58.00
CD3⁺CD8⁺(%)	65.60	19.00~48.00
CD4⁺/CD8⁺比值	0.29	0.90~3.60
CD3^-CD19⁺(%)	7.80	9.00~14.00
CD3^-CD56⁺(%)	0.80	10.00~19.80
CD3^-CD56⁺CD16⁺(%)	7.40	0~2.00
肺泡灌洗液
CD3⁺(%)	89.80	70.00^[2]
CD3⁺CD4⁺(%)	58.10	50.00^[2]
CD3⁺CD8⁺(%)	29.80	30.00^[2]
CD4⁺/CD8⁺比值	1.95	1.50~1.80^[2]
注：肺泡灌洗液参考范围参照文献[2]。

下载: 导出CSV

表 2 患者的免疫球蛋白水平

Table 2. The patient's immunoglobulin levels

血清总免疫球蛋白	治疗前	输注丙种球蛋白2.5 g/d，6 d后	参考范围
IgM(g/L)	0.86	0.18	0.40~2.30
IgA(g/L)	0.27	0.27	0.70~4.00
IgG(g/L)	1.46	1.77	7.00~16.00
C3(g/L)	0.86	1.00	0.90~1.80
C4(g/L)	0.23	0.26	0.10~0.40

下载: 导出CSV

参考文献(22)

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