title: Multimodal immunosuppressant therapy in steroid-refractory common variable immunodeficiency sprue: a case report complicating cytomegalovirus infection.
abstract: Immunodeficient patients can develop malabsorption, mimicking celiac disease clinically and histologically. Such individuals may also occasionally require immunosuppressive therapy for autoimmune disorders. We have identified a patient with common variable immunodeficiency (CVID)-associated sprue complicated by duodenal cytomegalovirus (CMV) infection following corticosteroid and ancillary immunomodulatory therapy. Ganciclovir and a modification of the immunosuppressant regimen improved both clinical symptoms and villous atrophy. To our knowledge, this is original documentation of duodenal CMV infection secondary to immunomodulatory therapy for steroid-refractory CVID-sprue.
authors.affiliation: Department of Laboratory Medicine, Peter Lougheed Centre, University of Calgary, Canada.
authors.forename: S A C
authors.initials: SA
authors.lastname: Medlicott
authors.forename: S
authors.initials: S
authors.lastname: Coderre
authors.forename: G
authors.initials: G
authors.lastname: Horne
authors.forename: R
authors.initials: R
authors.lastname: Panaccione
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004351:Drug Resistance; D004386:Duodenum / Q000187:drug effects / Q000473:pathology / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab; D016399:Lymphoma, T-Cell / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013256:Steroids / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000998:Antiviral Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D013256:Steroids; D000069285:Infliximab; D001379:Azathioprine; D015774:Ganciclovir; D011241:Prednisone