Skip to main content

Table 5 Initial and follow-up diagnostics in common variable immunodeficiency

From: Common variable immunodeficiency - an update

System Type of diagnostic procedure Intervals
Hematopoietic system Blood formula and differential blood counts (3-)6 months; more often in case of known
autoimmune cytopenia
  Coombs test in any case of newly developing anemia On demand
  Bone marrow biopsy in case of suspicion of lymphoma or myelodysplasia On demand at diagnosis or during follow-up
Immune system IgG, IgA, IgM (aiming at trough levels >7g/L)  
  In intravenous immunoglobulin-substituted patients Monthly trough levels
  In subcutaneous immunoglobulin-substituted patients 1-3 months
  Immunofixation in serum and urine, ß2-microglobulin At diagnosis
  CD3, CD4, CD8, CD19, CD56 lymphocyte subsets Initially and repeatedly in case of suspected combined immunodeficiency
  Vaccination responses to tetanus, diphtheria, hepatitis, pneumococcal polysaccharides At diagnosis
  Classification (detailed T/B-cell evaluation) At diagnosis
Microbiology (direct culture of pathogens, PCR, antigen ELISA) Purulent sputum: determine colonizing pathogens and resistance pattern to antibiotics On demand
  In case of chronic bronchiectasis, control of colonising pathogens (Pseudomonas spp., Haemophilius influenzae, Streptococcus pneumoniae, Staphylococcus aureus, Candida spp. and others) with sensitivity to antibiotics 6-12 months and on demand
Lungs Spirometry, CO diffusion test, blood gases 12 months
  Chest X-ray (12-)24 months
  HR-CT in case of proven GILD 24 months and on demand
  Bronchoscopy + BAL in case of suspicion of GILD At diagnosis; on demand
Lymphoproliferation Abdomen sonography CT-Abdomen/MRT 12 months
  Lymph node biopsy On demand; in case of suspected lymphoma
Gastrointestinal tract Oesophogastroscopy In case of clinical symptoms and every
   24 months in case of increased risk for developing intestinal malignancy
  Colonoscopy On demand
Central nervous system MRT, liquor analysis in case of neurological symptoms (exclusion of enteroviral infection) On demand
  1. BAL, bronchoalveolar lavage; CT, computed tomography; GILD, granulomatous interstitial lung disease; HR-CT, high-resolution computed tomography; MRT, magnetic resonance computed tomography.