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Chronic inflammatory bowel disease in a patient with common variable immunodeficiency
N Kütükçüler1, R V Yağci, S Aydoğdu
1Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.
The Turkish Journal of Pediatrics
|April 12, 2001
Summary
Common variable immunodeficiency (CVID) increases infection and autoimmune risks. This case highlights CVID patients developing chronic inflammatory bowel disease (CIBD), suggesting a potential link and need for monitoring.
Area of Science:
- Immunology
- Gastroenterology
Background:
- Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by impaired antibody production.
- Patients with CVID have an increased susceptibility to infections and a higher incidence of autoimmune disorders.
- Emerging evidence suggests a potential association between CVID and chronic inflammatory bowel disease (CIBD), with up to 20% of CVID patients potentially developing CIBD.
Observation:
- A nine-year-old male patient diagnosed with CVID presented with symptoms suggestive of CIBD.
- The patient was undergoing regular intravenous immunoglobulin (IVIg) therapy for CVID.
- Elevated serum tumor necrosis factor-alpha (TNF-α) levels were observed, a marker associated with CIBD activity.
Findings:
- The patient exhibited radiological findings consistent with CIBD during both active disease and remission phases.
- The clinical presentation and diagnostic evaluations confirmed the co-occurrence of CVID and CIBD in this pediatric patient.
- Tumor necrosis factor-alpha levels correlated with the disease activity of CIBD.
Implications:
- This case underscores the importance of recognizing and investigating gastrointestinal symptoms in CVID patients.
- It suggests that CIBD may be an underdiagnosed complication in individuals with CVID.
- Monitoring TNF-α levels and utilizing radiological assessments could aid in the diagnosis and management of CIBD in CVID patients.