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Chronic urticaria and common variable immunodeficiency (CVID): an association to remember
  1. Claudia Villatoro Santos and
  2. Michael Yacoub
  1. Internal Medicine, Ascension St John Hospital, Detroit, Michigan, USA
  1. Correspondence to Dr Claudia Villatoro Santos; Claudia.Villatoro.santos{at}


The patient is a 64-year-old Caucasian woman with idiopathic chronic urticaria who presented to her primary care physician’s office with mucoid otitis media. Medical history was significant for hypertension, hyperlipidaemia, allergic rhinitis, pre-diabetes, gastro-oesophageal reflux, paroxysmal atrial fibrillation, chronic kidney disease, diverticulosis with prior diverticulitis and history of recurrent infections. Her chronic urticaria was initially treated with antibiotics, antihistamines and oral steroids, but later she developed refractory urticaria requiring dapsone with modest improvement. When she presented with mucoid otitis media, immunoglobulin levels were found to be decreased. The pneumococcal vaccine antibody challenge confirmed the diagnosis of common variable immunodeficiency (CVID). Her HIV test was negative. She was started on intravenous immunoglobulin infusions and her chronic urticaria stabilised.

In patients with chronic urticaria refractory to treatment, especially with a history of recurrent infections, a diagnosis of CVID should be considered, regardless of HIV status.

  • dermatology
  • general practice / family medicine
  • immunology

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  • Contributors MY is the primary care physician for the patient and responsible for her final CVID diagnosis. He was also responsible for coordinating her care and revised and approved the contents of the final manuscript. CVS collected the patient’s information and wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.