Impaired nutritional status in common variable immunodeficiency patients correlates with reduced levels of serum IgA and of circulating CD4(+) T lymphocytes

Background Common variable immunodeficiency (CVT) is a primary defect of th e immune system. Infections, persistent diarrhoea and malabsorption may res ult in malnutrition, which may in turn contribute to increased morbidity. I n this paper, the prevalence of malnutrition in CVI was evaluated. Patients and methods Forty CVI patients (20 male, 20 female, aged 17-75 yea rs) underwent anthropometric measurements from which body mass index, arm f at and muscle area were calculated. Body mass index values <18.5 and arm fa t and muscle area values < 10th percentile were considered indicative of ma lnutrition. Patients were divided into four groups according to circulating CD4(+) T cells (lower or greater than 300 muL(-1)) and serum immunoglobuli n A (IgA) levels (detectable and undetectable). Results Body mass index < 18.5, arm fat and muscle area ( 10th percentile w ere observed in 23%, 58% and 44%, respectively, of patients. Lower values o f body mass index, arm fat and muscle area were more frequent in patients w ith low CD4(+) cells and undetectable IgA. Low arm fat values were more fre quent in patients with diarrhoea (P = 0.03). Infectious episodes were more frequent in undetectable IgA than in detectable IgA patients (P = 0.04). Conclusions Anthropometric measurements revealed an increased rate of malnu trition in CVI patients, particularly in those with low CD4(+) and undetect able IgA, suggesting that selected CVI subjects could be considered for sta ndard or specialized nutritional support.