A High Prevalence of Gastrointestinal Manifestations in Common Variable Immunodeficiency

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Pikkarainen , S , Martelius , T , Ristimäki , A , Siitonen , S , Seppanen , M R J & Färkkilä , M 2019 , ' A High Prevalence of Gastrointestinal Manifestations in Common Variable Immunodeficiency ' , American Journal of Gastroenterology , vol. 114 , no. 4 , pp. 648-655 . https://doi.org/10.14309/ajg.0000000000000140

Title: A High Prevalence of Gastrointestinal Manifestations in Common Variable Immunodeficiency
Author: Pikkarainen, Sampsa; Martelius, Timi; Ristimäki, Ari; Siitonen, Sanna; Seppanen, Mikko R. J.; Färkkilä, Martti
Contributor: University of Helsinki, Department of Medicine
University of Helsinki, Infektiosairauksien yksikkö
University of Helsinki, Department of Pathology
University of Helsinki, Department of Clinical Chemistry and Hematology
University of Helsinki, Children's Hospital
University of Helsinki, Centre of Excellence in Complex Disease Genetics
Date: 2019-04
Language: eng
Number of pages: 8
Belongs to series: American Journal of Gastroenterology
ISSN: 0002-9270
URI: http://hdl.handle.net/10138/301412
Abstract: OBJECTIVES: Common variable immunodeficiency (CVID) is associated with a spectrum of autoimmune complications. We studied the prevalence of gastrointestinal (GI) manifestations and infections in patients with CVID. METHODS: Complete clinical data of 132 Finnish patients with CVID (106 probable and 26 possible CVID) followed up between 2007 and 2016 were collected to a structured database. Data on endoscopies, histology, and laboratory studies were retrieved from patient files. RESULTS: Most common referral indications were diarrhea and/or weight loss (47%-67%). Patients with probable CVID had higher fecal calprotectin and a1-antitrypsin and lower blood vitamin B12 than patients with possible CVID. Gastroscopy and colonoscopy were done to 71 (67%) and 63 (59%) patients with probable CVID, respectively. Endoscopies showed that 15% of them had chronic active gastritis and 17% atrophic gastritis and 3% had gastric adenocarcinoma. A celiac sprue-like condition was found in 7 patients (10%), of whom 3 responded to a gluten-free diet. Colonoscopies demonstrated unspecific colitis (14%), ulcerative colitis (8%), microscopic colitis (10%), and Crohn's disease (2%). Colonic polyps were noted in30% of patients, and3% had lower GI malignancies. Thirty-five patients with CVID had bacterial or parasitic gastroenteritis; chronic norovirus was detected in 4 patients with probable CVID. Patients with GI inflammation had higher levels of fecal calprotectin and blood CD81 T lymphocytes but lower counts of CD191CD271 memory B cells and/or CD191 B cells. Immunophenotype with low B-cell counts was associated with higher fecal calprotectin levels. DISCUSSION: Patients with CVID had a high prevalence of GI manifestations and infections of the GI tract. GI inflammation was associated with a distinct immunophenotype and elevated fecal calprotectin.
3121 General medicine, internal medicine and other clinical medicine
3111 Biomedicine

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