Pediatric Common Variable Immunodeficiency

Common variable immunodeficiency (CVID) is an immunodeficiency problem that causes your child to have a low level of antibodies and a decreased responsiveness to some vaccines. This makes it hard for your child’s body to fight infections. Your child then becomes sick with infections that keep coming back. Most people with CVID become sick and are diagnosed as adults. But in some cases, the disease may become obvious after your child is two years old, during childhood or puberty. The symptoms of the disease are very different for each child affected. This is why it is called a variable group of disorders.

Experts don't know what causes CVID. The disorder causes a decrease in the number of immunoglobulins (antibodies) in a child who has it. Immunoglobulins are made by the body. They are needed to fight infections. In some cases, more than one person in a family may be affected.

The only known risk factor for CVID is a family history of the problem.

Each child may have slightly different symptoms. Symptoms may include:

• Infections that keep coming back in the eyes, skin, ears, sinuses and lungs. The more these infections happen, the greater the risk of scarring and lasting (permanent) damage to the lungs and breathing tubes.
• Inflammation in the joints of the knees, ankles, elbows or wrists
• Stomach and bowel problems
• Increased risk of developing some cancers, especially lymphomas and gastrointestinal cancers
• Autoimmune diseases

A diagnosis of CVID is often made based on a complete health history and physical exam. In addition, multiple blood tests may be ordered to help confirm the diagnosis. Testing for low serum IgG concentrations is key to diagnosing this health problem.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Treatment may include:

• Immunoglobulin replacement therapy. IV or subcutaneous infusions of immunoglobulin (antibodies) may be given to help boost your child’s immune system and replace the immunoglobulins that are needed.
• Medicine. Antibiotics to treat and prevent infection as prescribed by your child’s healthcare provider.
• Routine blood tests.
• Postural drainage of the lungs. These are special exercises or treatments for the lungs that are used in cases where frequent infections have led to scarring in the lung. Postural drainage may help with lung infections and removing secretions.

Infections, and the results of those infections, are the greatest complication of CVID. With correct treatment, the number and severity of infections should be reduced. Adults with CVID have an increased risk of developing cancer.

CVID is a lifelong health problem that can lead to a reduced ability to fight infections. The current therapies can reduce the number and severity of infections. Strategies include:

• Staying away from others who are sick.
• Having your child wash their hands often with soap and water.

Include your healthcare provider in the discussion about school attendance and after-school activities. Most children are able to take part in all activities, but they should use caution. They should not do activities when the risk for infection is higher.

It's also important that you work closely with a healthcare specialist who is familiar with CVID and the newest treatments.

Call the healthcare provider if your child’s symptoms get worse or if your child has new symptoms.