title: Duodenal pathology and clinical-immunological implications in common variable immunodeficiency patients.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Immunology, Department of Clinical Medicine, La Sapienza University, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Luzi
authors.forename: Angelo
authors.initials: A
authors.lastname: Zullo
authors.forename: Filippo
authors.initials: F
authors.lastname: Iebba
authors.forename: Vittorio
authors.initials: V
authors.lastname: Rinaldi
authors.forename: Lupe
authors.initials: L
authors.lastname: Sanchez Mete
authors.forename: Maurizio
authors.initials: M
authors.lastname: Muscaritoli
authors.forename: Fernando
authors.initials: F
authors.lastname: Aiuti
mesh_terms: D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000276:immunology*; D004378:Duodenal Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies