title: Immmunodeficiencies and autoimmune diseases: common variable immunodeficiency and Crohn-like.
abstract: Common variable immunodeficiency (CVI) gives a major risk of principally respiratory and digestive infections. It is associated with autoimmune diseases, granulomatous process and neoplasias. The digestive clinic is common, in 10% of patients it is the only symptom, and 60 % present chronic diarrhea. Clinically it can be confused and related with other pathologies such as inflammatory bowel disease which is infrequent (2-13%). We present the case of a patient with CVI with digestive symptoms being diagnosed of Crohn-like disease with extent ileal affectation. The main treatment of these patients is the same as classical Crohn disease although in the most severe cases, as this one, the use of immunosupresors is necessary. At this time the patient remains on clinical remmision with infliximab. She presented a previous adverse reaction with adalimumab. The few case series in this pathology makes the treatment with immunomodulators in this immunodeficiency a real diagnostic and therapeutic challenge.
authors.affiliation: Aparato Digestivo, Complejo Hospitalario de Navarra, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Saldaña Dueñas
authors.affiliation: Complejo Hospitalario de Navarra. Pamplona.
authors.forename: Saioa
authors.initials: S
authors.lastname: Rubio Iturria
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D001327:Autoimmune Diseases; D003113:Colonoscopy; D017074:Common Variable Immunodeficiency / Q000175:diagnosis / Q000473:pathology*; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000069285:Infliximab; D000068879:Adalimumab