CVID-Associated Bronchiectasis — RACP Adult Medicine MCQ

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ModerateRespiratoryCVID-Associated BronchiectasisRACP Adult Medicine

A 45-year-old woman with recurrent pneumonias and chronic sinusitis presents with lower-lobe bronchiectasis. Serum immunoglobulins show IgG 3.0 g/L (low), IgA <0.07 g/L (very low), IgM 0.2 g/L (low). Sweat chloride is normal. She has autoimmune thrombocytopenia. What is the most likely aetiology of bronchiectasis?

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Correct answer: D — Common variable immunodeficiency

Recurrent sinopulmonary infections with bronchiectasis, panhypogammaglobulinaemia, and autoimmune cytopenia (ITP) is CVID. It is the most common symptomatic primary immunodeficiency in adults. Bronchiectasis results from recurrent inadequately treated infections due to antibody deficiency. Treatment is lifelong immunoglobulin replacement therapy plus airway clearance.

Reference: ASCIA – 2024 – PID Guidelines; ERS 2024 Bronchiectasis