Treatment for CVID-
1)Ig may be administered intravenously or subcutaneously. Solutions of 3-12%
intravenous immunoglobulin (IVIG) can be used on a regular basis to maintain a trough level of 400-500 mg/dL in adults. A dose of 400-600 mg/kg every 2-4 weeks is usually required. In patients with structural lung damage, a trough level of 700-800 mg/dL is required.
2)Cyclosporin A has been successfully used in patients with CVID and lymphoid interstitial pneumonitis. The administration of anti-CD20 monoclonal antibody has been used to treat autoimmune
thrombocytopenia and neutropenia.
3)Antimicrobial therapy should be initiated at the first sign of infection. A narrow spectrum of drugs should be used when culture and sensitivity results are available. The prophylactic use of antibiotics should be avoided because of an increased risk of infection with fungi or other resistant organisms.
Specific therapy is often necessary to target the organ system involved. For instance, patients with
chronic lung disease often develop airway obstructive disease that requires treatment with inhaled
corticosteroids and other asthma medications
4)Surgery is required to treat the complications of common variable
immunodeficiency (CVID).
Chronic sinusitis may require endoscopic sinus surgery. Severe autoimmune thrombocytopenia or
hemolytic anemia can be treated with splenectomy. Biopsy should be considered to exclude infection or malignancy in enlarging lymph nodes.
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