Gastrointestinal Pathologic Abnormalities in Pediatric- and Adult-Onset Common Variable Immunodeficiency

Area of Science:

• Immunology
• Gastroenterology
• Pathology

Background:

• Common variable immunodeficiency (CVID) is a primary immunodeficiency with frequent gastrointestinal (GI) complications.
• Nearly 50% of CVID patients experience GI issues including gastritis, diarrhea, infections, and malabsorption.

Purpose of the Study:

• To investigate and compare gastrointestinal histopathological findings in pediatric and adult CVID patients.
• To correlate GI symptoms with histopathological changes in CVID.

Main Methods:

• Retrospective analysis of clinical and histopathological data from 22 CVID patients (13 children, 9 adults).
• Evaluation of duodenal biopsies for cellular infiltrates, lymphoid hyperplasia, and infections.

Main Results:

• Increased T lymphocyte infiltrate and absence of plasma cells in the duodenal lamina propria were common in both pediatric and adult CVID.
• Follicular lymphoid hyperplasia, polymorphonuclear infiltrate, and parasitic/viral infections were predominantly observed in adult CVID patients.
• Even CVID patients with minor GI symptoms showed pathological findings, including absent plasma cells and T cell infiltrates.

Conclusions:

• Gastrointestinal histopathological abnormalities are prevalent in both pediatric and adult CVID.
• Histological findings may differ based on age of onset, potentially related to disease duration.
• Minor GI symptoms in CVID warrant investigation for underlying pathological changes.