The following is a summary of “Pulmonary Computed Tomography Screening Frequency in Primary Antibody Deficiency,” published in the April 2024 issue of Allergy & Immunology by Smits, et al.

Patients with primary antibody deficiency (PAD) often experience pulmonary complications, which are associated with significant morbidity and mortality. Thus, regular computed tomography (CT) pulmonary screening is recommended. However, predictive factors for pulmonary morbidity in this patient population were lacking. For a study, researchers sought to identify patients with PAD at risk for pulmonary complications that require frequent CT screening.

They conducted a retrospective longitudinal cohort study of patients with PAD with a median follow-up of 7.4 years (range: 2.3-14.8 years). CT scans were evaluated using the modified Brody-II scoring system. Clinical and laboratory data were collected retrospectively. Potential risk factors were identified through univariate analysis (P < .2) and confirmed using multivariable logistic regression (P < .05).

Independent risk factors for airway disease (AD) progression included X-linked agammaglobulinemia (XLA) diagnosis, recurrent airway infections (2.5/year), and baseline AD presence. AD progression was observed in 5 of 11 patients with XLA and 17 of 80 other patients with PAD. Among the 22 patients who progressed, 17 had pre-existing AD scores ≥7.0%. Higher AD scores were associated with reduced forced expiratory volume in 1 second and chronic cough. Common variable immunodeficiency and elevated CD4 effector/memory cells were associated with interstitial lung disease (ILD) score ≥13.0%. ILD was present in 12 of 80 patients, and progression was detected in 8 of 80 patients, with 4 of 8 patients having pre-existing ILD scores ≥13.0%.

They identified risk factors that differentiate patients with PAD at risk for AD and ILD presence and progression, potentially guiding future screening strategies. However, independent validation, preferably through prospective studies, was necessary.

Reference: jaci-inpractice.org/article/S2213-2198(24)00004-7/fulltext