New diagnostic criteria could distinguish common variable immunodeficiency disorder from anticonvulsant‐induced hypogammaglobulinemia

Abstract

AbstractHypogammaglobulinemia is a well‐recognized complication of long‐term anticonvulsant drug use. Stopping or changing the anticonvulsant might result in resolution of the hypogammaglobulinemia. We determined the utility of our new diagnostic criteria for common variable immunodeficiency disorder (CVID) in a patient suffering from profound hypogammaglobulinemia who was taking anticonvulsants. Application of these criteria confirmed our patient had underlying CVID, making complete recovery of her immunoglobulins unlikely. Changing her drugs did not completely resolve her immune deficiency, and her seizure control deteriorated during this time. The partial recovery of her immunoglobulins showed that the anticonvulsants were also contributing to her hypogammaglobulinemia. In conclusion, the new diagnostic criteria we have proposed could identify patients with CVID taking anticonvulsants with greater precision, and will provide useful prognostic information. This might improve patient safety.