Primary Immunodeficiency and Fatigue

Prevalence of fatigue is higher in persons with primary immunodeficiency (PI), especially common variable immunodeficiency (CVID), and it greatly affects the individual’s quality of life, according to experts speaking at the 2022 Immune Deficiency Foundation PI conference, virtual event, in October 2022.

“Patients always said they were tired, not just from a bad night’s sleep, but a mom would tell me she can’t get out of bed to help her kids get ready for school or a man says I need to be on disability because I can’t work and I thought ‘This is really serious,’” said Dr Joud Hajjar, an assistant professor of medicine in the immunology, allergy, and rheumatology department at Baylor College of Medicine and Texas Children’s Hospital. She added that in her career as a clinical immunologist, she has noticed that patients with PI have repeatedly struggled with extreme fatigue.

Upon analyzing 2537 patients with PI from the USIDNET registry, investigators learned 25.9% of patients with PI reported fatigue compared to 6.4% of non-PI patients. Within the subsect of PI diagnoses, patients with CVID experienced a higher rate of fatigue. Additionally, fatigue was reported in higher numbers among females, patients with a higher body mass index, and patients who battled with depression, bronchiectasis, and autoimmunity.

Fatigue is a multidimensional concept, and it manifests in several independent dimensions such as physical, cognitive, motivational, and reduced activities, experts warn. “Most importantly, fatigue affects all ages,” Dr Hajjar said. “It is higher in those who use intravenous immunoglobulin therapy because the immunoglobulin levels drop, or wear off, more sharply than in subcutaneous immunoglobulin therapy. Fatigue affects the overall quality of life.”

—Priyam Vora

Reference:
Hajjar J, Louw K and Tachdjian R. Fatigue, pain, and PI: what do we know? Immune Deficiency Foundation 2019 National Conference Session. Oral presentation. June 22, 2019. DOI: https://primaryimmune.org/video/fatigue-pain-pi-what-do-we-know