title: Gastrointestinal Pathologic Abnormalities in Pediatric- and Adult-Onset Common Variable Immunodeficiency.
abstract: BACKGROUND
  Common variable immunodeficiency is the most common form of primary symptomatic immunodeficiency. Gastrointestinal manifestations, such as gastritis, diarrhea, gastrointestinal infections, and malabsorption, may complicate the clinical history in almost 50 % of patients.
  
  
  OBJECTIVE
  To evaluate gastrointestinal histopathological findings in pediatric- and in adult-onset common variable immunodeficiency patients.
  
  
  METHODS
  Twenty-two patients with common variable immunodeficiency (13 children, nine adults) were retrospectively studied from a clinical and histopathological point of view.
  
  
  RESULTS
  Increased T lymphocyte infiltrate and the absence of plasma cells in duodenal lamina propria and submucosa were the most frequent findings, independently from onset age, whereas follicular lymphoid hyperplasia and polymorphonuclear infiltrate, as well as parasitic and viral infections, were only present in the adult group. Common variable immunodeficiency patients with minor gastrointestinal symptoms also presented pathological findings, mainly the absence of plasma cells, T cell infiltrate, and infections, independently of age.
  
  
  CONCLUSIONS
  Gastrointestinal pathological abnormalities are common in both pediatric- and adult-onset common variable immunodeficiency patients. Histological alterations may vary depending upon the age of onset, possibly due to duration of disease. Minor gastrointestinal symptoms are also associated with pathological findings; therefore, these should be searched in all symptomatic patients.
authors.affiliation: Pediatrics Clinic, Department of Clinical and Experimental Sciences, Spedali Civili, University of Brescia, Brescia, Italy.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Lougaris
authors.forename: Alberto
authors.initials: A
authors.lastname: Ravelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
authors.forename: Marianna
authors.initials: M
authors.lastname: Salemme
authors.forename: Annarosa
authors.initials: A
authors.lastname: Soresina
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fuoti
authors.forename: Francesco
authors.initials: F
authors.lastname: Lanzarotto
authors.forename: Alberto
authors.initials: A
authors.lastname: Lanzini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Plebani
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
references.citation: J Clin Invest. 2010 Apr;120(4):1265-74
references.pmid: 20237408
references.citation: Clin Exp Immunol. 2007 Nov;150(2):306-11
references.pmid: 17822445
references.citation: Am J Gastroenterol. 2010 Oct;105(10):2262-75
references.pmid: 20551941
references.citation: Immunol Allergy Clin North Am. 2008 May;28(2):367-86, ix-x
references.pmid: 18424338
references.citation: N Engl J Med. 2006 May 4;354(18):1901-12
references.pmid: 16672701
references.citation: J Clin Invest. 2010 Jan;120(1):214-22
references.pmid: 20038800
references.citation: Lancet. 2008 Aug 9;372(9637):489-502
references.pmid: 18692715
references.citation: Proc Natl Acad Sci U S A. 2009 Aug 18;106(33):13945-50
references.pmid: 19666484
references.citation: N Engl J Med. 1954 Jun 17;250(24):1027-9
references.pmid: 13165949
references.citation: Clin Immunol. 2004 Dec;113(3):234-40
references.pmid: 15507387
references.citation: Dig Dis Sci. 2007 Nov;52(11):2977-83
references.pmid: 17431775
references.citation: Am J Gastroenterol. 2007 Jun;102(6):1322-5
references.pmid: 17531016
references.citation: Am J Surg Pathol. 2007 Dec;31(12):1800-12
references.pmid: 18043034
references.citation: J Allergy Clin Immunol. 2012 Mar;129(3):801-810.e6
references.pmid: 22035880
references.citation: Am J Gastroenterol. 2003 Jan;98(1):118-21
references.pmid: 12526946
references.citation: Nat Genet. 2005 Aug;37(8):820-8
references.pmid: 16007087
references.citation: Nat Genet. 2005 Aug;37(8):829-34
references.pmid: 16007086
references.citation: Gut. 1999 Jul;45(1):77-81
references.pmid: 10369708
references.citation: Am J Clin Pathol. 2012 Aug;138(2):185-9
references.pmid: 22904128