Primary hypoparathyroidism in a patient with common variable immunodeficiency associated enteropathy

Area of Science:

• Immunology
• Gastroenterology

Background:

• Common variable immunodeficiency (CVID) is a rare humoral immunodeficiency.
• CVID often leads to sinopulmonary and gastrointestinal infections.
• CVID can cause enteropathy, resulting in malnutrition and electrolyte deficiencies.

Observation:

• A 50-year-old male CVID patient presented with a 2-year history of cachexia and diarrhea.
• Endoscopy revealed enteropathic changes in the duodenum and colon.
• The patient had severe, treatment-resistant electrolyte and vitamin deficiencies, including hypocalcemia.

Findings:

• Celiac disease, inflammatory bowel disease, and infections were excluded as causes of diarrhea.
• Concomitant primary hypoparathyroidism was diagnosed.
• Oral replacement therapy was ineffective for the patient's deficiencies.

Implications:

• Parenteral therapy is recommended for refractory CVID enteropathy.
• Hypoparathyroidism is a rare but important consideration in CVID patients with unexplained hypocalcemia.
• This case highlights the complex interplay between CVID, enteropathy, and endocrine dysfunction.