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Harvard Medical School
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General Medical Questions
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Question : What is common variable immune deficiency? What type of specialist has the most expertise with this condition?
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The Trusted Source
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Howard LeWine, M.D.

Anthony L. Komaroff, M.D., is professor of medicine and editor-in-chief of Harvard Health Publications at Harvard Medical School. Dr. Komaroff also is senior physician and was formerly director of the Division of General Medicine at Brigham and Women's Hospital. Dr. Komaroff has served on various advisory committees to the federal government, and is an elected Fellow of the American Association for the Advancement of Science.

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January 12, 2011
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A:

Common variable immune deficiency is a disease of the immune system. The part of the system that produces antibodies does not work properly. The disease can start at a very young age, but usually becomes evident when people are in their 20’s. The cause is unknown.

With this disease, immune system cells called B cells do not develop properly. Normally, they turn into plasma cells, which make antibodies. But in people with common variable immune deficiency, plasma cells and antibodies are dangerously low. Because antibodies are critical in fighting off infections, people with this disease are prone to getting infections. They are particularly prone to bacterial infections of the:

  • Sinuses
  • Lungs
  • Eyes
  • Joints
  • Brain

People with common variable immune deficiency do not make antibodies when they are immunized, so vaccines don’t protect them very well.

For reasons that are not clear, people with this disease are also more vulnerable to autoimmune diseases like rheumatoid arthritis and pernicious anemia. They are particularly prone to autoimmune diseases of the gut, like inflammatory bowel disease.

People with common variable immune deficiency also are more vulnerable to getting cancer, particularly Non-Hodgkin lymphomas and stomach cancer. It is not clear why this is so.

Because people with common variable immune deficiency cannot make enough antibodies, they are treated with infusions of antibodies (immunoglobulin) every few weeks. It is very important for them and everyone who lives with them to guard against infection. Steps include regular hand washing and avoiding people who have infections. Friends and family must also keep up-to-date on their immunizations.

Doctors who specialize in immune system diseases and infectious diseases have the expertise to help people with this disease.

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