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Bronchiectasis due to immunodeficiency — SCE Respiratory MCQ

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HardRespiratory InfectionsBronchiectasis due to immunodeficiencySCE Respiratory

A 55-year-old woman has daily purulent sputum and recurrent infections. CT shows bronchiectasis in multiple lobes. Baseline tests reveal IgG 3.1 g/L, low IgA and poor pneumococcal antibody response. What is the most likely underlying cause?

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Correct answer: B — Common variable immunodeficiency

Multilobar bronchiectasis with recurrent infection and low immunoglobulins with poor vaccine response suggests common variable immunodeficiency. ABPA may cause bronchiectasis but would be associated with asthma, high IgE and Aspergillus sensitisation. Alpha-1 antitrypsin deficiency causes emphysema more than recurrent suppurative bronchiectasis.

Reference: BTS Guideline for Bronchiectasis in Adults 2018