122Lu Combined Variable Imunnodeficiency

50 m year old female  with combined variable immunodeficiency syndrome

  • 49 y.o. female
    • hx of
      • sinusitis, pneumonia, and bronchitis. bronchiectasis in setting of CVID.She was diagnosed with low IgG around 19 years ago and started on IgG replacement in 4 years later, the transitioned
    • Diagnosed with CVID due to low IgA and, later, low IgM.

3 years ago

Pulmonary Nodules and lymph – adenopathy splenomegaly

  • CT chest from 3 years ago
    • Interval increase in the size and number of numerous pulmonary nodules with
    • basal predominance compared to the prior
    • consistent with granulomatous lymphocytic interstitial lung disease
    • ? underlying/superimposed infection
    • stable bronchiectasis and consolidation in the medial right middle lobe and lingula.
    • Stable bilateral hilar lymphadenopathy.


1 year ago

Unchanged Symptoms

  • Interval increase in size, confluence, and number of irregular widespread pulmonary nodules.
    • suggestive of progressive granulomatous lymphocytic interstitial lung disease.
    • Stable right middle lobe and lingular peribronchial consolidations with bronchiectasis.
    • Stable mediastinal and hilar adenopathy.




  •  lack of fever or acute deterioration,
    • growth of the only normal upper respiratory flora on the recent sputum culture
    • Sputum culture negative
  • Imaging shows progressive
    • granulomatous interstitial lung disease (GL ILD) and
    • lymphocytic  interstitial lung disease
      • associated with CVI D
        • bronchiectasis