Management of Granulomatous Lymphocytic Interstitial Lung Disease With Rituximab in a Patient With Common Variable Immune Deficiency

Abstract

Common variable immunodeficiency (CVID) is the most prevalent clinically important form of primary immunodeficiencies (PID). CVID is characterized by a wide variability of complications which can affect almost all organs and systems. Infectious complications are more typical, but non-infectious complications, in particular granulomatous lymphocytic interstitial lung disease (GLILD), have more strong influence on the course, prognosis and severity of the disease and the patient’s quality of life. GLILD is a challenge not only from a diagnostic point of view (manifestations are often misdiagnosed and treated as sarcoidosis, tuberculosis, lymphoproliferative disease), but also in terms of treatment strategy selection. Rituximab - is one of the most promising methods of GLILD therapy, which showed its efficiency in limited clinical observations. A clinical case of successful treatment of GLILD associated with CVID, using rituximab on the background of a regular replacement immunotherapy with immunoglobulin for intravenous administration (IVIG) is described in this article.