Enteropathy in Common Variable Immunodeficiency

Gastrointestinal complications are frequent in patients with common variable immunodeficiency (CVID), with enteropathy being one of the main complications. Patients typically present with chronic diarrhea and abdominal pain, with frequently ensuing malabsorption, that can be severe. Various intestinal histopathological findings are described for these patients, but there are no clear diagnostic criteria to define this condition. Its etiopathogenesis also frequently remains unknown, which hinders efforts for an appropriate diagnostic and treatment pathway. This review summarizes evidence on the importance of infections in patients with CVID enteropathy, with pathogens such as norovirus, Giardia, Campylobacter, Salmonella, and cytomegalovirus being the most common. The distinction between infectious and noninfectious causes is of vital importance in these patients in order to institute treatment in a timely manner and prevent further complications. In cases of high clinical suspicion, the use of a comprehensive diagnostic approach is required, including molecular diagnostics and endoscopic tissue sampling.