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[Diarrhea and weight loss in common variable immunodeficiency].

Z Liesch1, C Hanck, B Werth

  • 1Departement Innere Medizin, Kantonsspital, Chur, Schweiz.

Zeitschrift Fur Gastroenterologie
|July 13, 2004
PubMed
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Common Variable Immunodeficiency Syndrome (CVID) can cause chronic diarrhea and malabsorption. Prompt immunoglobulin treatment alleviates symptoms, but complications like recurrent infections and organ damage may persist.

Area of Science:

  • Immunology
  • Gastroenterology
  • Pulmonology

Background:

  • Common Variable Immunodeficiency Syndrome (CVID) is a primary immunodeficiency characterized by impaired B-cell differentiation and low immunoglobulin levels.
  • Gastrointestinal manifestations, including malabsorption and chronic diarrhea, are common but often underdiagnosed in CVID patients.
  • Nodular Lymphoid Hyperplasia (NLH) of the small intestine is a frequent endoscopic finding in CVID, associated with malabsorption.

Observation:

  • A 25-year-old male presented with chronic diarrhea, weight loss, and recurrent pneumonia since childhood.
  • Endoscopy revealed nodular lymphoid hyperplasia (NLH) of the small intestine.
  • Laboratory findings indicated hypogammaglobulinemia, leading to a diagnosis of CVID.

Findings:

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  • Immunoglobulin replacement therapy rapidly resolved diarrhea and reduced pulmonary infections.
  • Despite treatment, the patient experienced persistent recurrent gastrointestinal infections (e.g., Giardia, Campylobacter).
  • Progressive bronchiectasis and splenomegaly were noted over the years, highlighting long-term complications.

    • Implications:

    • CVID should be considered in the differential diagnosis of unexplained chronic diarrhea and malabsorption, especially in patients with recurrent infections.
    • Early diagnosis and consistent immunoglobulin replacement are crucial for managing CVID symptoms and reducing infection rates.
    • Long-term monitoring is essential to manage progressive complications such as bronchiectasis and organomegaly in CVID patients.