{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:14:21Z","timestamp":1780344861220,"version":"3.54.1"},"reference-count":12,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,23]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>The patient is a 64-year-old Caucasian woman with idiopathic chronic urticaria who presented to her primary care physician\u2019s 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.<\/jats:p>\n               <jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2020-239733","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T16:14:47Z","timestamp":1612541687000},"page":"e239733","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Chronic urticaria and common variable immunodeficiency (CVID): an association to remember"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-6310","authenticated-orcid":false,"given":"Claudia","family":"Villatoro Santos","sequence":"first","affiliation":[{"name":"Internal Medicine, Ascension St John Hospital, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Internal Medicine, Ascension St John Hospital, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,5]]},"reference":[{"key":"2025082713095152000_14.2.e239733.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.07.025"},{"key":"2025082713095152000_14.2.e239733.2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1586\/eci.13.30","article-title":"A review on guidelines for management and treatment of common variable immunodeficiency","volume":"9","author":"Abolhassani","year":"2013","journal-title":"Expert Rev Clin Immunol"},{"key":"2025082713095152000_14.2.e239733.3","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s12016-017-8628-1","article-title":"Urticaria and angioedema: an update on classification and pathogenesis","volume":"54","author":"Radonjic-Hoesli","year":"2018","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025082713095152000_14.2.e239733.4","doi-asserted-by":"publisher","DOI":"10.1111\/all.12056"},{"key":"2025082713095152000_14.2.e239733.5","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/ijstd.IJSTD_10_17","article-title":"A study of clinicopathological correlation of pruritic papular eruptions in HIV patients","volume":"39","author":"Chopra","year":"2018","journal-title":"Indian J Sex Transm Dis AIDS"},{"key":"2025082713095152000_14.2.e239733.6","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1067\/mai.2002.127002","article-title":"Chronic urticaria and angioedema as the first presentations of common variable immunodeficiency","volume":"110","author":"Altschul","year":"2002","journal-title":"J Allergy Clin Immunol"},{"key":"2025082713095152000_14.2.e239733.7","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2019.01700","article-title":"Refractory chronic spontaneous urticaria treated with omalizumab in an adolescent with common variable immunodeficiency","volume":"10","author":"Comberiati","year":"2019","journal-title":"Front Immunol"},{"key":"2025082713095152000_14.2.e239733.8","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1016\/j.jaad.2007.09.011","article-title":"Common variable immunodeficiency presenting as chronic urticaria","volume":"59","author":"Smith","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"2025082713095152000_14.2.e239733.9","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.73.2.133"},{"key":"2025082713095152000_14.2.e239733.10","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1016\/j.jaip.2019.02.004","article-title":"The European Society for Immunodeficiencies (ESID) Registry Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity","volume":"7","author":"Seidel","year":"2019","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025082713095152000_14.2.e239733.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61199-X"},{"key":"2025082713095152000_14.2.e239733.12","doi-asserted-by":"crossref","first-page":"228","DOI":"10.29262\/ram.v64i2.187","article-title":"[Angioedema as initial manifestation of hypogammaglobulinemia]","volume":"64","author":"L\u00f3pez-Rocha","year":"2017","journal-title":"Rev Alerg Mex"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:09:58Z","timestamp":1756325398000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,5]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-239733"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239733","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}