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CVID — RACP Adult Medicine MCQ

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ModerateRespiratoryCVIDRACP Adult Medicine

A 40-year-old woman presents with recurrent sinopulmonary infections and bronchiectasis. Serum IgG is 1.2 g/L (normal 7–16), IgA is 0.1 g/L, and IgM is 0.3 g/L. Lymphocyte subsets show reduced memory B cells. What is the most likely diagnosis?

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Correct answer: A — Common variable immunodeficiency (CVID)

Panhypogammaglobulinaemia with recurrent sinopulmonary infections and bronchiectasis in an adult is the classic presentation of CVID, the most common symptomatic primary immunodeficiency. Reduced memory B cells on flow cytometry support the diagnosis. Treatment is lifelong immunoglobulin replacement therapy (IV or subcutaneous). Patients require monitoring for autoimmune complications, granulomatous disease, and lymphoproliferative disorders.

Reference: eTG – 2025 – Immunology; ESID – 2020 – CVID Diagnostic Criteria