Subtle But Clinically Significant: A Review of Antibody Deficiencies in Adults

Abstract

Primary immunodeficiency diseases are becoming more frequently diagnosed in the adult population. Although infections are the most common symptoms, patients can also present with sequelae of autoimmune and noninfectious pulmonary diseases, such as interstitial lung disease and granulomatous disease. Pulmonologists are likely to encounter patients with various and, at times, subtle symptoms suggestive of immunodeficiency. In this review article, we discuss the presentation, evaluation, and management of 4 antibody deficiencies: common variable immunodeficiency, selective immunoglobulin A deficiency, specific antibody deficiency, and immunoglobulin G subclass deficiency.