GLILD in a Population of Children and Young Adults Clinical Trial
Official title:
Granulomatous-Lymphocytic Interstitial Lung Disease (GLILD) Diagnosed in Children and Young Adults With Common Variable Immunodeficiency
8 to 22% of patients with common variable immunodeficiency (CVID) will develop Granulomatous Lymphocytic Interstitial Lung Disease (GLILD), which has emerged as a major cause of mortality. Little is known about GLILD in children and young adults. The aim of this study was to describe the clinical, functional, radiological and pathological features of children and young adults diagnosed with GLILD.
Variable common immunodeficiency (VCID) encompasses a heterogeneous group of primitive
immunodeficiencies, with variable clinical and immunological settings, but globally
characterized by hypogammaglobulinemia with significant reduction of Immunoglobulin G levels,
often associated with a decrease in Immunoglobulin A and/or Immunoglobulin M levels, coupled
with inability to produce antibodies in response to infection and/or immunization. VCID is
the most common primary immunodeficiency, with an estimated prevalence between 1/10,000 and
1/50,000. With the introduction of high-dose, intravenous or subcutaneous immunoglobulins,
number of infections, along with morbidity and induced mortality, has declined sharply in
recent years. Conversely, non-infectious complications, such as autoimmune manifestations,
inflammatory bowel diseases, enteropathies, hepatitis, lung disease and lymphoproliferation
(up to lymphoma), increased considerably, reaching 70% of patients.
Granulomatous Lymphocytic Interstitial Lung Disease is a non-infectious complication that can
occur during the evolution of VCID and which is usually the pulmonary manifestation of a
systemic polyclonal lymphoproliferative disease. GLILD contained both granulomatous and
lymphoproliferative histopathologic patterns such as lymphocytic interstitial pneumonia ,
follicular bronchiolitis, and lymphoid hyperplasia. In recent series, approximately 8 to 22%
of patients develop GLILD in VCID, and this complication is associated with increased
mortality.
Although there are now more studies conducted in the adult population, those in the pediatric
population are only currently case report. To the best of our knowledge, very little data is
available on this specific lung disease in the pediatric and young adults population.
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