Gastrointestinal complications in two patients with common variable immunodeficiency

ABSTRACT

Common variable immunodeficiency [CVID] is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections especially in respiratory and gastrointestinal systems. We present here 2 cases of CVID with gastrointestinal complications. Case 1 is a 25-year-old man with a history of chronic diarrhoea from childhood. Ultrasonography revealed ascites, with liver size smaller than normal. Liver biopsy showed non-specific hepatitis. Lymphoid proliferation and Histiocytosis were reported in his ascites cytology. Moreover friability in colonoscopy due to moderate active chronic colitis was detected. Case 2 is a 26-year-old man with chronic diarrhoea since 8 years. Abdominal sonography revealed increased liver echogenicity, increased liver size, and some enlarged lymph nodes beside pancreas. Colonoscopy revealed friability and decreased vascularity while biopsy showed moderate active chronic colitis. Lymph node biopsy showed unusual immunologic reaction. Moreover, small bowel transition test showed nodularity. CVID should be considered in any patient with gastrointestinal manifestations especially chronic diarrhoea in association with recurrent bacterial infections in other organs. Diagnostic delay results in more morbidity and complications in untreated patients