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. 2010 May;33(5):347-51.
doi: 10.1016/j.gastrohep.2009.12.012. Epub 2010 Mar 1.

[Gastrointestinal manifestations in patients with primary immunodeficiencies causing antibody deficiency]

[Article in Spanish]
Affiliations

[Gastrointestinal manifestations in patients with primary immunodeficiencies causing antibody deficiency]

[Article in Spanish]
Rubén Díez et al. Gastroenterol Hepatol. 2010 May.

Abstract

Introduction: Primary immunodeficiencies can lead to gastrointestinal manifestations that are still not well defined.

Objective: To analyze gastrointestinal manifestations associated with primary immunodeficiencies.

Material and methods: We performed a retrospective study that included patients diagnosed with primary antibody deficiencies in a third-level hospital. The patients were divided into two groups: isolated IgA deficiency and common variable immunodeficiency syndrome (CVIS). The timing of presentation and type of gastrointestinal symptoms were analyzed.

Results: There were 57 patients: 20 with CVIS (35%) and 37 with isolated IgA deficiency (65%). Diagnosis was made in the pediatric age in 17 patients, of whom 13 had isolated IgA deficiency. In 84% of the patients, diagnosis of immunodeficiency was made before the development of gastrointestinal manifestations. Digestive symptoms were found in 74% of the patients, the most frequent being diarrhea. In 46% of the patients, digestive disease was confirmed, mainly through endoscopy. Celiac-like lesions, chronic atrophic gastritis, ulcerative colitis-like disease and Crohn's disease were more common in CVIS. In isolated IgA deficiency, Helicobacter pylori-positive chronic gastritis predominated. Mean age was significantly higher (36 vs. 24 years, p=0.02) and IgA titer significantly lower (17 vs. 34UI/ml; p=0.008) in patients with associated gastrointestinal disease.

Conclusions: Gastrointestinal symptoms are frequent and lead to endoscopic diagnosis in half of patients with primary immunodeficiencies. Ulcerative colitis, and celiac- and Crohn's-like disease are atypical entities that occur in CVIS.

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