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[Chronic diarrhea as a clinical expression of common variable hypogammaglobulinemia: apropos of 3 cases]
Insights
Common variable hypogammaglobulinemia (CVH) can cause chronic diarrhea in immunocompromised patients. This study highlights three late-onset CVH cases presenting with chronic diarrhea, emphasizing the need for specialized teams in diagnosis and management.
Area of Science:
- Immunology
- Gastroenterology
- Clinical Medicine
Background:
- Chronic diarrhea affects up to 60% of patients with humoral immunodeficiency.
- Common variable hypogammaglobulinemia (CVH) is a primary immunodeficiency often presenting with recurrent infections, but also gastrointestinal symptoms.
Abstract:
Sixty per cent of the patients with immuno-compromise of the humoral compartment may show chronic diarrhoea, specially seen in the common variable hypogammaglobulinemia (CVH). We presented 3 cases of late-onset CVH who referred chronic diarrhoea as the main symptom. The immunodiagnosis revealed undetectable or subnormal immunoglobulins levels (G, M, A), preserved total haemolytic complement and a negative autoimmune screening. The cell compartment analysis showed increased number of suppressor T lymphocytes (CD8) plus hyporesponsiveness of the total peripheral lymphocytes to polyclonal mitogens such PHA. The clinical approach of the CVH patients should be performed by a multispecialized team including the clinical immunologist and the gastrointestinal and infectious diseases specialists.