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Area of Science:

  • Immunology
  • Gastroenterology
  • Oncology

Background:

  • Common variable immunodeficiency (CVID) is a primary immunodeficiency associated with significant gastrointestinal (GI) complications and an elevated risk of gastric cancer.
  • Patients with CVID often experience diverse GI manifestations, necessitating comprehensive diagnostic approaches.

Observation:

  • A case of CVID with mild anemia is presented, exhibiting multiple complex GI issues.
  • These manifestations included gastric low-grade dysplasia (LGD), enteropathy with villous atrophy, persistent Giardia infection, nodular lymphoid hyperplasia, and inflammatory bowel-like disease.

Findings:

  • The CVID enteropathy with villous flattening mimicked celiac sprue, complicating differential diagnosis.
  • The presence of gastric LGD in this CVID patient underscores the heightened risk for gastric malignancy.

Implications:

  • Accurate diagnosis of GI conditions in CVID patients can be challenging due to overlapping features.
  • Establishing appropriate gastric cancer surveillance protocols for CVID patients with LGD is crucial for early detection and management.