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Abstract Details

Evaluation of the Prevalence of Headache and Pain of Unknown Cause in Patients with Common Variable Immunodeficiency (CVID) Evaluate the Prevalence of Headache and Pain in Patients with Common Variable Immunodeficiency (CVID)
Autoimmune Neurology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
15-004
Evaluate the prevalence of headache and pain in patients with common variable immunodeficiency (CVID).

CVID is an immune-deficiency syndrome associated with recurrent infections, and poor vaccine response with onset after 2 to 4 years old. Though correlative links between CVID and various organ systems have been identified, little research has been done evaluating the association between this disorder and neurologic symptoms.

Prospective survey of 71 adult patients with CVID seen at the University of Utah Immunology Clinic; diagnosis based upon the European Society of Immune Deficiencies (ESID) and the Pan American Group for Immune Deficiency guidelines.  We evaluated headache and pain severity using the Migraine Disability Assessment (MIDAS) test and the Indiana Polyclinic pain scale. A standard student t-test was used to compare the mean scores of CVID patients to the general population and multiple sclerosis (MS) populations. 

Of the 71 patients, mean age was 50.4; 76.9% were female. Headache was reported by 84.3% of CVID patients, compared to a range of 21-36% in MS patients. The mean MIDAS score in CVID patients was 20.41 (±42.9SD, p-value = 0.026) compared to MS patients. Pain of unknown cause was reported by 76% of patients with CVID with a mean 2.83 (±1.9SD, p-value = 0.88) and is comparable to MS patients.

Headache rates and related disability were significantly higher in CVID patients than MS patients and the general population. CVID patients reported  pain rates higher than the general population and comparable to MS patients.  Neither headache nor pain are commonly reported in the CVID literature, and are thus largely under-recognized, raising concern for under-treatment. The evolution, causes and management of pain in CVID are areas needing further study, including the possibility that intravenous immune globulin infusions may exacerbate headache.
Authors/Disclosures
Lawanda Esquibel
PRESENTER 		No disclosure on file
Bruno I. De Almeida (Unversity of Utah) No disclosure on file
Leah Millsap, PhD (University of Utah) Dr. Millsap has nothing to disclose.
Jonathan R. Galli, MD (University of Utah) Dr. Galli has nothing to disclose.
No disclosure on file
M. M. Paz Soldan, MD, PhD (Mayo Clinic) Dr. Paz Soldan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. The institution of Dr. Paz Soldan has received research support from National Multiple Sclerosis Society. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. The institution of Dr. Paz Soldan has received research support from Biogen. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Paz Soldan has received research support from Clene Nanomedicine.
Julia Klein, NP (University of Utah School of Medicine) An immediate family member of Ms. Klein has received personal compensation for serving as an employee of Amgen. An immediate family member of Ms. Klein has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen.
Melissa M. Cortez, DO (University of Utah Neurology) The institution of Dr. Cortez has received research support from NIH NINDS. The institution of Dr. Cortez has received research support from Dysautonomia International. Dr. Cortez has received personal compensation in the range of $500-$4,999 for serving as a Content Expert, Reviewer, DSMB with NIH RECOVER project.
John W. Rose, MD, FÂ鶹´«Ã½Ó³»­ (Imaging and Neurosciences Center) The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
John E. Greenlee, MD, FÂ鶹´«Ã½Ó³»­ (University of Utah) Dr. Greenlee has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink. Dr. Greenlee has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Zeigler Cohen Roche. Dr. Greenlee has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Sommers Schwartz PC. Dr. Greenlee has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for St Francis Hospital. Dr. Greenlee has received publishing royalties from a publication relating to health care. Dr. Greenlee has received publishing royalties from a publication relating to health care.
Harry H. Hill, MD No disclosure on file
Ka-Ho Wong (U of U Neurology Clinic) The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
Stacey Clardy, MD, PhD, FÂ鶹´«Ã½Ó³»­ (University of Utah) Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/Â鶹´«Ã½Ó³»­ Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. The institution of Dr. Clardy has received research support from Kyverna. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Â鶹´«Ã½Ó³»­ Summer Meeting CoDirector Travel and Lodging with Â鶹´«Ã½Ó³»­. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Advent Health Florida, Beaumont Health, CCF, Emory, Penn State Health, Mayo Clinic, Walter Reed.