Resumen
La inmunodeficiencia común variable (IDCV) es la inmunodeficiencia sintomática más común en la edad adulta. El diagnóstico de IDCV es de exclusión y debe considerarse en pacientes de cualquier edad que presenten hipogammaglobulinemia sin causa conocida. Numerosos pacientes con IDCV presentan alteraciones en el desarrollo de los linfocitos B, tanto en las células plasmáticas como de memoria. La ausencia de células B de memoria sugiere una reacción germinal insuficiente que puede asociarse con bloqueo de la transición de células T1 a T2 en pacientes con IDCV, debido a deficiencia del receptor BAFF (factor activador de linfocitos B). En pacientes con IDCV, las alteraciones en las células B de memoria con cambio de isotipo favorecen el desarrollo de comorbilidades concomitantes como linfadenopatía, esplenomegalia, autoinmunidad y enfermedad granulomatosa, por lo que se han realizado múltiples clasificaciones de IDCV que utilizan en común a las células B de memoria para intentar establecer factores pronósticos.
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