Low Platelet Level May be a Predictor for Mortality in Adult Patients with Common Variable Immune Deficiency
Abstract
Background: Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults. We, therefore, aimed to reveal mortality rates, causes of mortality in CVID patients, as well as demographic and clinical characteristics and differences of survived and dead CVID patients
Methods: The study group included 50 patients [(Female: 23 (46%), Male: 27 (54%)] with CVID, who were followed up on a regular basis for a period of ten years (115.18 ± 80.74 months).
Results: Diagnostic delay was 84 (0-360) months, and the mean follow-up time was 115.18 ± 80.74 months. The most common clinical presenting complaints were frequent and recurrent infections and pneumonia. At diagnosis, serum IgG levels were 1.72 (0.33 – 6.90) g/L. The overall survival rate of the patients during the follow-up time was 88%. As a result of univariate Cox regression analysis, platelet count was determined to be an independent risk factor for mortality in CVID patients (Hazard ratio, HR: 0.990, 95% confidence interval, CI: 981-0.999, p: 0.025). When the patients were classified according to mean platelet counts (platelets < 207770/mm3 and platelets > 207770/mm3), the mortality rate in the patient group with platelets < 207770/mm3 was determined to be statistically significantly higher compared to the patient group with platelets > 207770/mm3 (log-rank: 0.013).
Conclusions: Clinicians dealing with this patient group should remember that immune dysregulation and low platelet count are independent risk factors for mortality and they should remarkably follow up patients with low platelet count closely.
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