AB 72. Follicular bronchiolitis associated with
underlying common variable immunodeficiency
Background: Follicular bronchiolitis is a benign lymphoproliferative
disorder of the lungs. We report the case of a patient diagnosed with
follicular bronchiolitis that after investigation was attributed to common
variable immunodeficiency disorder.
Patients and methods: A 35-year-old female patient was admitted to
our Department suffering from fever up to 38.0 ℃ for the last 3 months.
At her admission the patient was febrile with a mild non productive
cough. Her blood screen showed leucopenia and anemia. The CXR
was within normal limits, but the lung HRCT demonstrated regions
with ground glass opacities interchangeable with nodular regions at
the lower lobes bilaterally, the medium lobe and lingula in addition to
bronchiolectasies. Bronchoscopy was not revealing. Bronchoalveolar
lavage was of medium cellularity with a high percentage of lymphocytes
up to 43%, of neutrophils 10% and of eosinophils 1%. Pulmonary
function tests showed a restrictive pattern. On the grounds of an
increased suspicion of lymph tissue malignancy, the patient underwent
bone marrow biopsy and peripheral blood immunophenotype.
The biopsy was negative for malignancy and an important decrease
of B lymphocytes was found by the bone marrow aspiration. The immunological check of the patient revealed a significant low value
of IgG immunoglobulin and a considerable decrease of the value of
IgG and IgA. Two years before her admission to our Department, the
patient was investigated for recurrent incidents of fever and radiological
imaging of interstitial lung disease.
Results: Lung biopsy by the method of Video Assisted Thoracoscopy
diagnosed follicular bronchiolitis. She was treated with corticosteroids
for approximately 8 months without any response. The final diagnosis
of common variable immunodeficiency was set and intravenous
immunoglobulin replacement therapy was initiated to the patient.
Conclusions: Pulmonary manifestations of common variable
immunodeficiency disorder, apart from lung infections, include
interstitial lung diseases among which follicular bronchiolitis.
Cite this abstract as: Spyropoulos G, Papakosta D, Sionidou M, Boura P,
Matzarakis I, Zarogoulidis K. Follicular bronchiolitis associated with underlying
common variable immunodeficiency. J Thorac Dis 2012;4(S1):AB72. DOI: