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. 2020 Aug;3(4):162-168.
doi: 10.1093/jcag/gwz004. Epub 2019 Feb 25.

Gastrointestinal Disease in Patients with Common Variable Immunodeficiency: A Retrospective Observational Study

Rishad Khan  1 , Mohamad Habbal  1 , Michael A Scaffidi  1 , Abbas A Bukhari  1 , Amir Rumman  1 , Sarah Al Ghamdi  1 , Stephen D Betschel  2 , Samir C Grover  1
Affiliations

Gastrointestinal Disease in Patients with Common Variable Immunodeficiency: A Retrospective Observational Study

Rishad Khan et al. J Can Assoc Gastroenterol. 2020 Aug.

Abstract

Background: Gastrointestinal (GI) symptoms are common among patients with common variable immunodeficiency disorder (CVID) yet remain poorly understood.

Aims: The aim of this study was to characterize the demographic, clinical, endoscopic and histologic features of patients with CVID and GI symptoms.

Methods: We conducted a retrospective observational study of all patients with CVID at a large Canadian tertiary care centre between January 2000 and May 2018.

Results: We included 95 patients with CVID. The mean age of patients at the time of CVID diagnosis was 38.2(±16.0). Fifty-three (56%) patients were female. Sixty-four (67%) patients had GI symptoms, with a mean age of onset for GI symptoms of 43.4(±15.1) years. The most common symptoms were bowel movement changes (n = 55 [58%]) and abdominal pain (n = 44 [46%]). Patients with GI symptoms were more likely to have anemia (n = 23 [36%] versus n = 3 [10%], P = 0.0129), iron deficiency (n = 16 [25%] versus n = 2 [7%], P = 0.0481), and have received GI antibiotics (n = 37 [58%] versus n = 0, P < 0.0001) and proton pump inhibitors for reflux (n = 24 [38%] versus n = 3 [10%], P = 0.0067). The most common GI infections were Giardia lamblia (n = 14 [15%]) and Clostridium difficile (n = 4 [4%]). Forty-three (45%) patients with GI symptoms underwent colonoscopy, esophagogastroduodenoscopy or both. The most common findings were inflammation, nodular lymphoid hyperplasia, reduced plasma cells and increased intraepithelial lymphocytes.

Conclusions: This is the largest study on CVID patients in a North American setting. The majority of patients experienced GI symptoms. Future studies should study response to treatment for GI disease among patients with CVID.

Keywords: Colitis; Common variable immunodeficiency; Enteropathy.

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Figures

Figure 1.
Figure 1.
IgG trough levels, IgA and IgM levels are presented in mg/dL. There were no significant differences when comparing patients with gastrointestinal symptoms to those without.
Figure 2.
Figure 2.
Flow cytometry analysis for absolute lymphocyte, CD3+, CD4+, CD8+ and CD19+ cell counts. There were no significant differences when comparing patients with gastrointestinal symptoms to those without.
See this image and copyright information in PMC

References

    1. Agarwal S, Smereka P, Harpaz N, et al. . Characterization of immunologic defects in patients with common variable immunodeficiency (CVID) with intestinal disease. Inflamm Bowel Dis 2011;17(1):251–9. - PMC - PubMed
    1. Bonilla FA, Barlan I, Chapel H, et al. . International Consensus Document (ICON): Common variable immunodeficiency disorders. J Allergy Clin Immunol Pract 2016;4(1):38–59. - PMC - PubMed
    1. Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: Clinical and immunological features of 248 patients. Clin Immunol 1999;92(1):34–48. - PubMed
    1. Chapel H, Cunningham-Rundles C. Update in understanding common variable immunodeficiency disorders (CVIDs) and the management of patients with these conditions. Br J Haematol 2009;145(6):709–27. - PMC - PubMed
    1. Cunningham-Rundles C. Clinical and immunologic analyses of 103 patients with common variable immunodeficiency. J Clin Immunol 1989;9(1):22–33. - PubMed

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