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CVID with Respiratory Complications — RACP Paediatrics MCQ

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HardRespiratoryCVID with Respiratory ComplicationsRACP Paediatrics

A 5-year-old child presents with chronic rhinosinusitis, bronchiectasis, and recurrent otitis media. Sweat chloride is normal. Nasal NO is normal. Immunoglobulins are low (IgG 2.5 g/L, IgA <0.1 g/L). What is the most likely underlying diagnosis?

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Correct answer: A — Common variable immunodeficiency

Recurrent sinopulmonary infections with low immunoglobulins (especially low IgG with low IgA) suggests CVID. Normal sweat chloride excludes CF. Normal nasal NO makes PCD unlikely. CVID is the most common symptomatic primary immunodeficiency and is managed with immunoglobulin replacement therapy.

Reference: RACP – 2024 – Paediatric Curriculum: Immunology