Granulomatous renal disease in a patient with common variable immunodeficiency

Common variable immunodeficiency (CVID), the most common cause of primary h ypogammaglobulinemia, Is characterized by a decreased serum immunoglobulin level, recurrent infections, and the occurrence of various autoimmune disea ses. Granulomatous disease has been reported previously In several patients with CVID, with granuloma occurring in the lymph nodes, spleen, liver, cen tral nervous system, and bone marrow. We report the first published case of renal granulomatous disease in a CVID patient presenting with subacute ren al failure. Renal function partially recovered after corticosteroid treatme nt and intravenous immunoglobulin Infusions. The pathogenesis of granulomat ous disease in CVID is unclear but may involve monocyte and T-cell abnormal ities. (C) 2001 by the National Kidney Foundation, Inc.