The aim of our study was to assess the evolution of hepatosplenic involvement during medium and long-term follow-up in patients with Common Variable Immunodeficiency (CVID) by annual abdominal ultrasound (US).

We retrospectively analyzed the annual abdominal US of 52 patients (29 male; 23 female), who referred for CVID to the Immunodeficience Unit of the University of Naples Federico II between 2004 and 2017. They were followed-up for at least 4 years and up to 13 years. In particular, we evaluated the longitudinal diameters of each liver lobe (right, left and caudate), the splenic longitudinal diameter, the portal vein diameter, the liver and the spleen echotexture.

In all of our patients we observed a significant and progressive increase of the liver and spleen size. In particular, we noticed in a subgroup (10 patients; 20%) of our sample that the liver longitudinal diameters were constantly augmented and a progressive echotexture alteration was associated. Indeed, at first, the liver appeared inhomogeneously hyperechoic (bright liver), then its surface was irregular and finally a coarse liver pattern was noticed. Furthermore, these ultrasonographic features preceded the alteration of the laboratory parameters. In all patients the portal...

In according to the literature (1, 2, 3), our data confirm the progressive hepato-splenic damage in patients with CVID. Nowadays, the pathological mechanisms are poorly defined, Pulvirenti et al. (4) proposed the involvement of primary antibody deficient, frequent inflammations and lymphocyte abnormalities, typical of these patients. In this contest, the abdominal US, a free-radiation, widely available and repeatable exam, plays an important role and to perform it regularly is fundamental (5), in order to identify precociously the subgroup of patients in which the liver damage...

M. Caruso, MD, University of Naples "Federico II", Department of Advanced Biomedical Sciences, Via S. Pansini, 5, 80131, Naples, Italy. Phone: +393478412472; +39 081 7463102; e-mail: [email protected]

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