In case of recurrent wheezing and bronchiolitis: Think again, it may be a primary immunodeficiency

Asian Pac J Allergy Immunol. 2022 Dec;40(4):442-446. doi: 10.12932/AP-260719-0610.


Background: Wheezing, starting early in life, is a heterogeneous medical condition caused by airway obstruction due to different underlying mechanisms. Primary immunodeficiencies are also among the risk factors that cause wheezing and recurrent bronchiolitis. ADA deficiency is a primary immunodeficiency, also a rare metabolic disease associated with multisystemic clinical findings.

Objective: This report will be helpful for adressing the importance of thinking primary immunodeficiency in case of wheezing and recurret bronchiolitis.

Methods: The patient was diagnosed by using a targeted next generation sequencing PID panel. Lymphocyte subsets were measured by flow-cytometry.

Results: Here we present an infant with ADA deficiency who admitted with wheezing and recurrent bronchiolitis as the first presentation. He was found to have wheezing, relative CD4+ T cell deficiency, and prolonged neutropenia.

Conclusions: Primary immunodeficiencies including ADA deficiency should be considered in infants with wheezing, recurrent bronchiolitis, lymphopenia and neutropenia.

MeSH terms

  • Agammaglobulinemia*
  • Bronchiolitis* / complications
  • Bronchiolitis* / diagnosis
  • Humans
  • Infant
  • Male
  • Neutropenia* / complications
  • Respiratory Sounds / etiology

Supplementary concepts

  • Severe combined immunodeficiency due to adenosine deaminase deficiency