OBJECTIVES: Common variable immunodeficiency (CVID) is an immunological disorder characterized by defective antibody production. An increased prevalence of celiac disease has been suggested in patients with this disorder. This study aimed to assess duodenal pathology and its clinical implications in these patients. METHODS: A total of 32 consecutive CVID patients with anemia or GI symptoms were enrolled. Patients underwent upper endoscopy, and biopsy specimens were taken in the descending duodenum for histological assessment. A blood sample was obtained to determine immunoglobulin and Hb levels and to evaluate the CD4+ T-lymphocyte count. Body mass index was calculated for all patients. RESULTS: Histological assessment of duodenal specimens revealed the presence of villous atrophy in 10 (31.2%) patients, a feature of nodular lymphoid hyperplasia in five (15.6%), and mild duodenitis in two (6.3%), whereas normal histology was observed in the remaining 15 (46.9%) patients. Patients with villous atrophy had anemia more frequently than those without, whereas the frequency of persistent diarrhea did not differ between these two groups. Moreover, both CD4 levels and body mass index were significantly lower in patients with atrophy than in controls. CONCLUSIONS: Duodenal villous atrophy is very frequent in symptomatic CVID patients, with relevant clinical and immunological implications. Specifically, this histological alteration is significantly associated with anemia, malnutrition, and low blood CD4+ lymphocyte levels.
OBJECTIVES: Common variable immunodeficiency (CVID) is an immunological disorder characterized by defective antibody production. An increased prevalence of celiac disease has been suggested in patients with this disorder. This study aimed to assess duodenal pathology and its clinical implications in these patients. METHODS: A total of 32 consecutive CVIDpatients with anemia or GI symptoms were enrolled. Patients underwent upper endoscopy, and biopsy specimens were taken in the descending duodenum for histological assessment. A blood sample was obtained to determine immunoglobulin and Hb levels and to evaluate the CD4+ T-lymphocyte count. Body mass index was calculated for all patients. RESULTS: Histological assessment of duodenal specimens revealed the presence of villous atrophy in 10 (31.2%) patients, a feature of nodular lymphoid hyperplasia in five (15.6%), and mild duodenitis in two (6.3%), whereas normal histology was observed in the remaining 15 (46.9%) patients. Patients with villous atrophy had anemia more frequently than those without, whereas the frequency of persistent diarrhea did not differ between these two groups. Moreover, both CD4 levels and body mass index were significantly lower in patients with atrophy than in controls. CONCLUSIONS: Duodenal villous atrophy is very frequent in symptomatic CVIDpatients, with relevant clinical and immunological implications. Specifically, this histological alteration is significantly associated with anemia, malnutrition, and low blood CD4+ lymphocyte levels.
Authors: Silje F Jørgensen; Henrik M Reims; Didrik Frydenlund; Kristian Holm; Vemund Paulsen; Annika E Michelsen; Kristin K Jørgensen; Liv T Osnes; Jorunn Bratlie; Tor J Eide; Christen P Dahl; Ellen Holter; Rune R Tronstad; Kurt Hanevik; Hans-Richard Brattbakk; Fatemeh Kaveh; Torunn Fiskerstrand; Anne-Marte B Kran; Thor Ueland; Tom H Karlsen; Pål Aukrust; Knut E A Lundin; Børre Fevang Journal: Am J Gastroenterol Date: 2016-08-16 Impact factor: 10.864
Authors: Kultigin Turkmen; Melih Anil; Yalcin Solak; Huseyin Atalay; Hasan Esen; Halil Z Tonbul Journal: Ann Saudi Med Date: 2010 Sep-Oct Impact factor: 1.526