Gastrointestinal complications in two patients with common variable immunodeficiency.

Area of Science:

• Immunology
• Gastroenterology

Background:

• Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia.
• Patients often experience recurrent bacterial infections, particularly in the respiratory and gastrointestinal systems.

Purpose of the Study:

• To present two cases of CVID with significant gastrointestinal complications.
• To highlight the importance of considering CVID in patients with unexplained gastrointestinal symptoms.

Main Methods:

• Case report of two adult males diagnosed with CVID.
• Detailed clinical presentation including chronic diarrhea, imaging findings (ultrasonography, small bowel transition test), and endoscopic/biopsy results (liver, colon, lymph nodes).

Main Results:

• Both cases presented with chronic diarrhea, colitis, and abnormal liver findings.
• Case 1 showed ascites and non-specific hepatitis; Case 2 exhibited increased liver echogenicity, enlarged lymph nodes, and small bowel nodularity.
• Histopathological examination revealed moderate active chronic colitis and unusual immunologic reactions in lymph nodes.

Conclusions:

• CVID should be suspected in patients with gastrointestinal manifestations, especially chronic diarrhea, coupled with recurrent bacterial infections.
• Delayed diagnosis of CVID leads to increased morbidity and complications.