Computed tomography scan assessment of lung disease in primary immunodeficiencies

A wide spectrum of lung disease can complicate primary immunodeficiencies a nd early recognition influences management and prognosis. Computed tomograp hy (CT) especially high resolution computed tomography (HRCT) has been show n to detect lung disease in adult immunodeficient patients often when the c hest radiograph (CXR) is normal, but this has not been studied in children. Twenty-five CT scans [10 HRCT] and CXRs were reviewed in 23 children [14 m ale, 9 female] with primary immunodeficiency. Eighteen [72%] of the CT scan s were abnormal, bronchiectasis being the commonest finding present in eigh t CT scans in patients with antibody deficiency. In eight cases CT scan rev ealed changes not seen on CXR (bronchiectasis;interstitial changes; small p arenchymal nodules; air trapping;and a small upper lobe cyst) which influen ced treatment in six cases. Conclusion CT scans have a valuable role in assessing lung disease in child ren with primary immunodeficiencies and will detect important changes not v isible on CXR.