Common Immunodeficiency Research Articles

Exploring Issues of Comorbid Conditions in People Who Smoke.

Smoking affects comorbid disease outcomes, and patients with comorbid conditions may have unique characteristics that are important to consider when treating tobacco use. However, addressing tobacco in patients being treated for comorbid conditions is not a consistent practice. Recognizing the need for a "call-to-action" to address tobacco use in people with comorbid conditions, the Tobacco Treatment Network within the Society for Research on Nicotine and Tobacco (SRNT) convened a Comorbidities Workgroup to explore the relationship between smoking and comorbid disease to identify common themes including: the harms associated with continued tobacco use, the frequency of comorbid disease and tobacco use, the potential effect of comorbid disease on the ability to quit tobacco use, the association between tobacco use and suboptimal disease-specific treatment response, and evidence regarding potential approaches to improve addressing tobacco use in patients with comorbid disease. Five candidate conditions (psychiatric, cancer, cardiovascular, pulmonary, and human immunodeficiency virus infected patients) were explored. Across comorbid conditions, smoking adversely affects treatment efficacy and promotes other adverse health conditions. People with comorbid conditions who smoke are motivated to quit and respond to evidence-based smoking cessation treatments. However, tobacco cessation is not regularly incorporated into the clinical care of many individuals with comorbidities. Optimal strategies for addressing tobacco use within each comorbid disease are also not well defined. Further work is needed to disseminate evidence-based care into clinical practice for smokers with comorbid disease and addiction research should consider comorbid conditions as an important construct to explore. This article explores how physical and psychiatric conditions may interact in the treatment of tobacco dependence, and discusses the need for smoking cessation as a critical component of comorbid condition management. Five common comorbid domains-psychiatric, cancer, pulmonary, cardiovascular, and human immunodeficiency virus (HIV)-are highlighted to illustrate how these different conditions might interact with smoking with respect to prevalence and harm, motivation to quit, and cessation treatment utilization and success.

Giardiasis and Protein-Losing Enteropathy as the Presenting Signs for Common Variable Immunodeficiency in an Adult Male

Introduction: Common variable immunodeficiency (CVID) is the second most common immunodeficiency behind IgA deficiency. We present a case of CVID in an adult male with primarily gastrointestinal manifestations. Case: A 28 year old Caucasian male in Air Force basic training was referred to urgent care for new onset lower extremity edema. He was found to have elevated liver associated enzymes and protein malnutrition on initial labs. On review of systems he reported a history of diarrhea with rectal outlet bleeding. Subsequent labs revealed a normal urine protein level, deficiency in vitamins A, E, D, and K. Elevated fecal α1-antitrypsin suggestive of protein losing enteropathy was also noted. Serologic workup evaluating for hemochromatosis, α1-antitrypsin deficiency, Wilson's disease, autoimmune hepatitis, celiac disease, acute and chronic viral hepatitis were negative. Stool studies evaluating for ova and parasites, giardia, clostridium difficile, and stool culture were obtained and was notable for giardia. On further questioning denied knowledge of the infection or associated risk factors such as drinking water from a well, river or stream, anal-oral sexual contact or contact with an infected individual. Evaluation with colonoscopy was unremarkable but esophagogastroduodenoscopy was notable for villous blunting within the duodenum and biopsies were obtained. Histology revealed giardia, intraepithelial lymphocytes, and a lack of plasma cells concerning for CVID. He was treated with a single dose of tinidazole with reported resolution of loose stools. Quantitative immunoglobulins revealed a low IgM and IgG consistent with the diagnosis of CVID.Figure 1Figure 2Figure 3Discussion: Common variable immunodeficiency is characterized by reduced concentrations of IgG in combination with a reduction in IgA and/or IgM, poor or absent response to immunizations, and lack of other immunodeficiency states. Nearly all patients develop infection with a bacterial pathogen or giardia. Clinical manifestations of the gastrointestinal tract include gastrointestinal inflammatory disease, malabsorption, protein losing enteropathy, liver disease/hepatitis, inflammatory bowel-like disease, and gastrointestinal lymphoma. Histology typically reveals villous atrophy, increased intraepithelial lymphocytes and a lack of plasma cells in those with small bowel pathology, and were present in our patient. The lack of plasma cells is especially notable given his active giardiasis.

Primary Immunodeficiency Diseases in Saudi Arabia: a Tertiary Care Hospital Experience over a Period of Three Years (2010-2013).

Primary immunodeficiencies (PID) are a group of heterogeneous diseases. Epidemiological studies from databases worldwide show geographical variation. In this study the objective is to determine the spectrum of PID in Saudi Arabia by analyzing the database in a referral tertiary hospital. This is a prospective data collection by interviews and medical chart review for all PID patients followed at the King Faisal Specialist Hospital & Research Center (KFSH&RC) from May 2010 to April 2013. A total of 502 patients presented (53 % male and 47 % female). Combined immunodeficiencies were the most common (59.7 %), followed by predominantly antibody deficiencies (12.3 %), congenital defects of phagocyte (9.4 %), combined immunodeficiencies with associated or syndromic features (6.2 %), disease of immune dysregulation (6 %), complement deficiencies (5.8), and defects in innate immunity (0.6 %). The most common combined immunodeficiencies phenotype was T-B-SCID (17 %). The patients' ages ranged from less than 1 year old to 78 years, and 394 patients (78.2 %) are in the paediatrics age group (<14 years). The overall mean age of symptoms onset was 17 months and the overall mean delay in diagnosis was 21.6 months. Recurrent infections were the most common occurring clinical presentation (66 %), followed by family history (26 %). Consanguinity was found in 75 % of the patients. A total of 308 (61 %) patients had undergone stem cell transplantation (SCT). The study revealed that combined immunodeficiencies are not uncommon and are the most frequent occurring diagnosis in our patient population. This study is a prerequisite to establish a national registry of primary immunodeficiency in Saudi Arabia.

Malnutrition and vaccination in developing countries.

Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge.

Valacyclovir Decreases Plasma HIV-1 RNA in HSV-2 Seronegative Individuals: A Randomized Placebo-Controlled Crossover Trial.

Acyclovir (ACV), a highly specific anti-herpetic drug, acts as a DNA chain terminator for several human herpesviruses (HHVs), including HHV-2 (HSV-2), a common human immunodeficiency virus (HIV)-1 co-pathogen. Several trials demonstrated that HSV-2 suppressive therapy using ACV or its prodrug valacyclovir (valACV) reduced plasma HIV-1 viral load (VL) in HIV-1/HSV-2 coinfected persons, and this was proposed to be due to a decrease in generalized immune activation. Recently, however, we found that ACV directly suppresses HIV-1 ex vivo in tissues free of HSV-2 but endogenously coinfected with other HHVs. Here, we asked whether valACV suppresses VL in HIV-1 infected HSV-2-seronegative persons. Eighteen HIV-1 infected HSV-2-seronegative individuals were randomly assigned in a double blind placebo-controlled, crossover trial. Eligible participants had CD4 cell counts of ≥500 cells/µL and were not taking antiretroviral therapy. Subjects in group A received 12 weeks of valACV 500 mg given twice daily by mouth followed by 2 weeks of a no treatment washout and then 12 weeks of placebo; subjects in group B received 12 weeks of placebo followed by 2 weeks of no treatment washout and then 12 weeks of valACV 500 mg twice daily. HIV-1 VL in plasma of patients treated with valACV 500 mg twice daily for 12 weeks was reduced on average by 0.37 log10 copies/mL. These data indicate that the effects of valACV on HIV-1 replication are not related to the suppression of HSV-2-mediated inflammation and are consistent with a direct effect of ACV on HIV-1 replication.

The pattern of hypogammaglobulinaemia in Sri Lankan children.

To evaluate the prevalence of hypogammaglobulinaemia in Sri Lankan children who present with recurrent or severe bacterial infections. A descriptive study. Medical Research Institute (MRI), Colombo. 100 children between the ages of four months to twelve years referred to the Department of Immunology, MRI, for evaluation of immune status during four years from 1993 to 1997. Immunoglobulin G, A and M levels were measured using radial immunodiffusion technique. 22 out of 100 children had an underlying antibody deficiency, of whom IgA deficiency was the commonest (18 patients). Two patients had low IgG and A and elevated IgM levels, and they were diagnosed as having X linked-hyper-IgM syndrome. One patient had deficient IgA and IgM, and all three immunoglobulins were deficient in another. Results indicate that IgA deficiency is the commonest immunodeficiency in Sri Lanka, which is comparable with studies done in the West. This study also shows the need to improve the standard of care in patients with immunodeficiency.

Autoimmune Encephalitis as the Sole Presentation of Common Varaible Immunodeficiency: First Report in a Child

Background: Common Variable Immunodeficiency (CVID) is a clinically heterogeneous antibody deficiency syndrome. The usual presentation is with recurrent respiratory infections. There is a strong association between CVID and autoimmune disorders. However, for CVID to present initially and solely with Autoimmune Encephalitis (AIE) is extremely rare. Case report: A previously healthy three years old boy presented with acute encephalopathy and intractable seizures. His clinical features and radiological findings were highly suggestive of AIE. His evaluation has revealed findings consistent with diagnostic criteria of CVID. Recurrent infections have later on evolved during his prolonged illness. Discussion: Both CVID and AIE pose a diagnostic difficulty. The prevalence of autoimmune disorders in CVID patients’ cohort can be up to 50%. However, central nervous system involvement in those patients is rare. The authors are not aware of this presentation being reported in children. Conclusion: In young children presenting with unexplained autoimmune encephalitis, investigations of immune system my reveal CVID, and timely and appropriate management would could be initiated.

Catastrophic neurologic manifestations of a common immunodeficiency syndrome

Catastrophic neurologic manifestations of a common immunodeficiency syndrome

Specific antibody deficiency: cases serie

Specific antibody deficiency is a common antibody immunodeficiency defined as a poor antibody response to pneumococcal polysaccharides antigens present in the 23-valent pneumococcal vaccine, with normal immunoglobulins and normal response to protein antigens. Clinical manifestations include recurrent sinopulmonary infections, severe infections and asthma. The aim of this presentation is to describe clinical manifestations and evolution of a cohort of children with specific antibody deficiency diagnosed and followed in our center between 1998 and 2012.

Longitudinally extensive transverse myelitis: a rare association with common variable immunodeficiency

Transverse myelitis requires careful investigation, as although many causes respond acutely to immunomodulation, the longer term management depends upon its precise cause. We describe a patient presenting acutely with a...

Relative IgA-deficient recipients have an increased risk of severe allergic transfusion reactions.

Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma-containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA-deficient patients who were transfused with unwashed blood products. Patients who had an IgA measurement performed for any reason over a 10-year period were compared with a list of transfusion recipients over the same period. Those who had both an IgA measurement and a transfusion were then compared with the transfusion reaction database to determine whether an allergic reaction had been reported, and if so, the severity of the reaction. Patients with IgA concentrations of <7mg/dL were defined as relative IgA deficient. Of the 22362 IgA measurements performed on 19737 patients over 10years, a total of 168 relative IgA-deficient patients were identified; 39 of these patients were also transfusion recipients and 4 of 39 (10%) experienced a severe allergic transfusion reaction (SALTR). Eight SALTRs were reported amongst 1545 (0·52%) IgA replete transfusion recipients. The significantly increased risk of SALTRs in relative IgA-deficient patients warrants consideration of premedications and/or washing of plasma-containing blood products.

AAOA allergy primer: immunodeficiency.

Primary immunodeficiency is rare but should be considered in patients who present to the otolaryngologist with recurrent, severe, or treatment refractory infections. Recent literature and consensus statements on immunodeficiency were reviewed for clinically important information of relevance to otolaryngologists. The most common and most relevant immunodeficiencies are humoral deficiencies with inadequate antibody production or an impairment in the production of specific antibody after antigen exposure. For otolaryngologists the most important immunodeficiencies include immunoglobulin A (IgA) deficiency, common variable immunodeficiency (CVID), and specific antibody deficiency. Simple screening tests can be used by the otolaryngologist to exclude the most common immunodeficiencies. The general treatment approach to patients with these immunodeficiencies includes airway hygiene, early and aggressive treatment of infections, immunization, and antibody replacement therapy. By virtue of their scope of practice, otolaryngologists are in a position to recognize and initiate the diagnostic workup of patients with immunodeficiency. Patients with a diagnosed primary immunodeficiency are best managed in a multidisciplinary manner with close cooperation among the otolaryngologist, immunologist, and other specialists that are involved in treating these multisystem diseases.

Antrinių imunodeficitų apžvalga

Straipsnyje apžvelgiamos dažniausios antrinio imunodeficito priežastys. Imuninį atsaką neigiamai paveikti gali tiek išoriniai, tiek vidiniai veiksniai, o dėl to padidėja infekcinių, piktybinių ir autoimuninių ligų rizika. Koregavus antrinio imunodeficito priežastį, imuninis pažeidimas paprastai išnyksta.

ICON: The Early Diagnosis of Congenital Immunodeficiencies

Primary immunodeficiencies are intrinsic defects in the immune system that result in a predisposition to infection and are frequently accompanied by a propensity to autoimmunity and/or immunedysregulation. Primary immunodeficiencies can be divided into innate immunodeficiencies, phagocytic deficiencies, complement deficiencies, disorders of T cells and B cells (combined immunodeficiencies), antibody deficiencies and immunodeficiencies associated with syndromes. Diseases of immune dysregulation and autoinflammatory disorder are many times also included although the immunodeficiency in these disorders are often secondary to the autoimmunity or immune dysregulation and/or secondary immunosuppression used to control these disorders. Congenital primary immunodeficiencies typically manifest early in life although delayed onset are increasingly recognized. The early diagnosis of congenital immunodeficiencies is essential for optimal management and improved outcomes. In this International Consensus (ICON) document, we provide the salient features of the most common congenital immunodeficiencies.

AB1116 Selective ig a deficiency in juvenile SLE patients

BackgroundImmunoglobulin A (IgA) is responsible for protection against infections of the respiratory and gastrointestinal tracts, and selective IgA deficiency (SIgAD) is the most common humoral immunodeficiency. It is speculated that...

Impaired thymic function and CD4 + T lymphopenia, but not mannose-binding lectin deficiency, are risk factors for Pneumocystis jirovecii pneumonia in kidney transplant recipients

Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in kidney transplant recipients (KTR), but risk factors remain poorly defined. CD4+ T lymphopenia and mannose-binding lectin (MBL) deficiency are common immunodeficiencies in KTR. Here, we investigated whether CD4+ T lymphopenia and/or MBL deficiency would be risk factors for PCP in KTR. Furthermore, the role of thymic function in CD4+ T lymphopenia and outcome was studied by assessing CD45RA+CD31+CD4+ T cell numbers (RTE, recent thymus emigrants).In 321 de novo KTR serial determinations of peripheral T lymphocyte subsets (n=281, mean 4.2 times between days 0–365) and/or MBL levels (n=112, mean 1.8 times between days 30–180) were performed. 22/321 patients developed a PCP episode on average at day 199 (107–398) post-Tx.Age correlated inversely with RTE, CD4+ and CD8+ T-cell counts until day 180 post-Tx. RTE correlated with CD4+ T-cell counts at all time-points pre- and post-Tx. PCP patients had more CMV infections (p=0.045) within the first 3months compared to controls. Importantly, PCP patients were older (p=0.008), and had lower RTE (p=0.046) pretransplant, and lower CD4+ T-cell counts pretransplant (p=0.017), at day 60 (p=0.032) and for the average of all post-Tx values (p=0.027) compared to controls. Though treatment with T-cell depleting antibodies was associated with consecutive CD4+ T lymphopenia in the whole cohort, the number of patients who received T-cell depleting antibodies was comparable between PCP and control patients (p=0.754). A multivariate stepwise logistic regression model identified only pretransplant CD4+ T-cell counts (OR 0.011, p=0.010) and acute rejection (OR 4.66, p=0.023) as predictors of PCP.In contrast, MBL levels and incidence of MBL deficiency (<500ng/ml) at days 30, 90 and 180 post-Tx were not different between PCP patients and controls.In conclusion, PCP risk was associated with higher age and related to both thymic functional impairment and long-lasting CD4+ T-lymphopenia that started already before transplantation. Despite frequent occurrences in KTR, low levels of serum MBL were not associated with increased risk for PCP. CD4+ T-cell counts and function should be addressed in prospective studies for more individualized approaches to PCP prophylaxis.

Successful treatment of an HIV-positive patient with unmasking Kaposi's sarcoma immune reconstitution inflammatory syndrome

BackgroundKaposi's sarcoma (KS) continues to be the most common human immunodeficiency virus (HIV)-associated neoplasm with considerable morbidity and mortality. While lesions normally resolve upon initiation of antiretroviral therapy (ART), recrudescence or unmasking of KS lesions may occur as part of immune reconstitution inflammatory syndrome (IRIS). Treatment of unmasking KS-IRIS is not yet standardised. ObjectivesTo report the successful treatment of a patient with fulminating mucocutaneous unmasking KS-IRIS by maintaining ART and using pegylated liposomal doxorubicin (PLD). Study designThe patient, a 39-year-old HIV-positive male with no previous history of KS presented with a 2-week history of cutaneous and oral KS lesions that had disseminated rapidly over the preceding 4 days. The KS lesions appeared 8 weeks after recommencing ART. At the time of this presentation, his CD4+ count was 742cells/mm3 with a HIV viral load <400copies/ml. ART was maintained and treatment with PLD commenced. ResultsDespite the rapid dissemination of KS lesions, virus was undetectable in plasma. In a late-stage vasoformative lesion, immunohistochemistry (IHC) for human herpesvirus 8 (HHV-8) antigen was light and diffuse, with stippled deposits within endothelial cell nuclei. Virus extracted from the lesion was HHV-8 subtype A. The patient responded well to PLD, relapsed a year later, but after further PLD, has remained well for the following 5 years. ConclusionDespite the absence of HHV-8 viraemia, this is clearly a case of unmasking KS-IRIS. It demonstrates that this entity can be successfully treated by maintaining ART and administering PLD.

Thrombopoietin Receptor Agonist (ELTROMBOPAG) for Chronic Immune Thrombocytopenic Purpura (ITP) Treatment: 21 Patients in Only One Center

AbstractAbstract 4658 IntroductionITP management has changed since thrombopoietin receptor agonists (TRAs) were approved for its treatment. Current TRAs are recommended for adults at risk of bleeding who relapse after splenectomy, as well as for those where splenectomy is contraindicated and where, at least, one other therapy has failed.The goal of this paper is to present the results of the treatment and follow-up of 21 patients treated with Eltrombopag in our Centre during the last year. PatientsWe present 21 patients diagnosed with chronic ITP according to the American Society of Hematology guidelines. 7 of them were males and 14 females. The median age was 70 years (range from 26 to 81 years). Previous splenectomy was undergone in 3 patients. 10 patients had previously received two or more therapies for ITP. 11 patients received TRAs as second line treatment. ResultsOn average, platelet counts at the beginning of the treatment with Eltrombopag were 23.000/μL. All patients started with the same doses (50 mg) except one of them who started with 25 mg. Patients only received concurrent ITP therapy (corticosteroids and intravenous immunoglobulins) when platelet counts were under 20,000/μL or bleeding occurred.8 patients needed rescue medications throughout the treatment with Eltrombopag (7 of them only once). Eltrombopag was withdrawn in a total number of 8 patients due to different reasons: 4 patients were considered as non-responders (3 of them didn't achieve a certain platelet count to prevent major bleeding and, in the fourth one, reducing or suspending the concurrent ITP therapy was not possible. One of these non-responders received Romiplostin and a good response was achieved). In one patient, the therapy was withdrawn due to liver toxicity and in another one, at patient's request. Finally, Eltrombopag was withdrawn in 2 patients because a sustained platelet counts was held. ConclusionTRAs are safe, effective and well-tolerated for those patients who relapse after splenectomy or when splenectomy is contraindicated. In our experience, TRAs could be also useful in other diseases like HCV or HIV associated thrombocytopenia. Eltrombopag and Romiplostin bind in different places to the TPO receptor (TPO-R). This circumstance, together with the different activation pathways, may explain that some non-responders to Eltrombopag could respond to Romiplostin and viceversa.PatientAgeComorbiditiesPrevious treatmentFollow upSide effecsResponse181Atrial Fibrillation High blood pressure (HBP)PRD, IVIG, Azathioprine6 mOedema peripheral dizzinessWithdraw/Intolerance243Thyroid cancer (CR)PRD, IVIG7 mNoneSustained338HCV+PRD, IVIG Azathioprine Splenectomy1 y 4mNoneSustained479HBP Breast cancer (CR)PRD, IVIG11 mDry mouthSustained526AVN of the femoral headPRD, IVIG6 mNoneSustained672COPD. DM. Heart attack. Aortocoronary bypassPRD,IVIG11 m 15 dNoneSustained773HysterectomyPRD, IVIG, Rituximab, Romiplostim6 mNoneSustained839NonePRD e IgG7 mNoneSustained980HBP. AsthmaPRD. IVIG Romiplostim5 mNoneSustained1052NonePRD, IVIG4 mNoneSustained1170HBP. DM. Stroke (2004) Multinodular goiter.PRD, IVIG, dapsona, Splenectomy3 m 15 dDiarrheaSustained/Withdraw1278HBP. DM. Bypass F-T, Leg Amputation, GlaucomaPRD, IVIG2 m y 7 dHepatotoxicityWithdraw/Toxicity1377VCIPRD, IVIG3 mNoneWithdraw/NR1481HBP. Stroke (1999) Prostate carcinoma (CR)PRD, IVIG4 mNoneSustained1581HBPPRD, IVIG, Romiplostim1 m 15 dNoneWithdraw/NR1639VCI. Chronic atrophic gastritisPRD, IVIG y Rituximab2 mNoneWithdraw/NR1775Chronic renal failurePRD, IVIG15 dNoneSustained1825NonePRD, DXM, IVIG, Rituximab, Splenectomy11 mNoneSustained1954NonePRD, IVIG Azathioprine Splenectomy Rituximab3 mNoneWithdraw/NR2042NonePRD, IVIG, Rituximab11 mNoneSustained2147HIV+PRD, IVIG6 mNoneSustained/WithdrawHBP: High blood pressure. PRD: prednisone. IgG: intravenous immunoglobulins. CR: complete response. NR: non response. AVN: Avascular necrosis. COPD: chronic obstructive pulmonary disease. DM: diabetes mellitus. Bypass femoro-tibial. VCI: variable common immunodeficiency. DXM: Dexamethasone. Disclosures:No relevant conflicts of interest to declare.

Fine‐needle cytology of Kaposi's sarcoma in an intramammary lymphnode: Report of one case

Kaposi's sarcoma (KS) is the most common human immunodeficiency virus (HIV) infection disease-associated malignancy. It consists of an angiosarcomatous change of the epithelial and mucous membrane-associated connective tissue not only in various sites, for example, skin, gastrointestinal system, lungs, and so on, but may also involve nonepithelial organs, such as lymphnodes. An unusual localization of KS to an intramammary lymphnode is reported here. The patient, an HIV-negative 69-year-old woman with a clinical history of rheumatoid arthritis treated with hydrocortisone, had an 8-month pathological history of biopsy-proven Kaposi sarcoma of the skin with visceral extension (stomach and duodenum). The appearance of a well-defined 23 × 20 mm(2) breast nodule during chemotherapy elicited fine-needle cytology to exclude breast carcinoma. Surgical excision confirmed the cytopathological diagnosis of Kaposis's sarcoma.

99 Anxiety and Depression in Patients With Variable Common Immunodeficiency in the Service of Allergy and Clinical Immunology - Centro Médico Nacional Siglo XXI

BackgroundDepression and anxiety disorder are topics of interest, not only to psychiatrists. It comes in a 10 to 20% of cases, with the highest figures in people with chronic diseases. It has been shown that depressed patients have more mortality (not only attributable to suicide) than the general population. Depressive disorders in the community reach a lifetime prevalence of 15%. The average age of onset is situated close to 30 years, being similar in both sexes. The Variable Common Immunodeficiency (ICV) is a disorder characterized by low levels of immunoglobulins (Ig), these patients have an increased susceptibility to infection. The exact cause of low levels of serum Ig is not known and autoimmune diseases is complicated by up to 20%. It has a prevalence estimated at 1 in 25,000, is the most common primary immunodeficiencies, however, the diagnosis is not made until the third and fourth decade of life.ObjectiveTo evaluate the presence of anxiety disorders and depression in patients with ICV.MethodsA cohort study, observational, cross-fifteen patients (11 female and 4 male) with ICV, aged between 17 and 71, diagnosed with ICV. Are individually applied assessment instruments and the preparation of tables and graphs. The data were expressed in absolute figures and percentages.Results1) 13.3% had very severe, 6.6% had severe, 13.3% moderate and 66.6% mild depression. 2) 33.3% moderate-severe anxiety and 66.6% mild.ConclusionsIn this study, most patients are between the second and third decade of life, the moderate-severe anxiety was found in 5 patients and mild in 10 patients, a mild depression 10, a moderate 2, a severe 1 and 2 very severe. This allows to evaluate the ability of the patient with ICV to accept their illness and see the level of infection on the psychological, and offer a multidisciplinary therapy with counseling and/or psychiatric treatment for patients with moderate-severe anxiety and moderate depression to very severe and thus improve their quality of life. These patients have associated autoimmune disorders and family problems.