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伴有多种胃肠道表现的普通可变免疫缺陷

Common Variable Immunodeficiency with Several Gastrointestinal Manifestations.

作者信息

Atalaia-Martins Catarina, Barbeiro Sandra, Marcos Pedro, Cotrim Isabel, Vasconcelos Helena

机构信息

Gastroenterology Department, Centro Hospitalar de Leiria, Leiria, Portugal.

出版信息

ACG Case Rep J. 2017 Aug 30;4:e106. doi: 10.14309/crj.2017.106. eCollection 2017.

DOI:10.14309/crj.2017.106
PMID:28879211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5577031/
Abstract

Common variable immunodeficiency (CVID) is an immunodeficiency disorder with a high incidence of gastrointestinal (GI) manifestations and an increased risk of gastric malignancy. We report a case of a CVID with mild anemia presenting with multiple GI manifestations: gastric low-grade dysplasia (LGD), enteropathy with villous atrophy, refractory Giardia infection, nodular lymphoid hyperplasia, and inflammatory bowel-like disease. The differential diagnosis with celiac sprue could be challenging because of CVID enteropathy with villous flattening. Gastric LGD in a patient with an increased risk for gastric malignancy makes the appropriate surveillance of gastric cancer in CVID challenging.

摘要

普通可变型免疫缺陷（CVID）是一种免疫缺陷疾病，胃肠道（GI）表现发生率高，患胃恶性肿瘤风险增加。我们报告一例患有轻度贫血的CVID病例，该病例有多种胃肠道表现：胃低级别上皮内瘤变（LGD）、伴有绒毛萎缩的肠病、难治性贾第虫感染、结节性淋巴样增生以及炎症性肠病样疾病。由于CVID肠病伴有绒毛变平，与乳糜泻的鉴别诊断可能具有挑战性。胃恶性肿瘤风险增加的患者出现胃LGD使得对CVID患者进行适当的胃癌监测具有挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/6df36221c62f/CG-CGCR170075F004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/97747ec5dfd2/CG-CGCR170075F001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/8bf69fa75db2/CG-CGCR170075F002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/459f82ca02c3/CG-CGCR170075F003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/6df36221c62f/CG-CGCR170075F004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/97747ec5dfd2/CG-CGCR170075F001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/8bf69fa75db2/CG-CGCR170075F002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/459f82ca02c3/CG-CGCR170075F003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca0/5577031/6df36221c62f/CG-CGCR170075F004.jpg

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本文引用的文献

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Curr Gastroenterol Rep. 2016 Apr;18(4):17. doi: 10.1007/s11894-016-0491-3.
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International Consensus Document (ICON): Common Variable Immunodeficiency Disorders.国际共识文件（ICON）：常见变异型免疫缺陷病
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Nodular lymphoid hyperplasia in the gastrointestinal tract in adult patients: A review.
原发性免疫缺陷病与胃肠道不适：缓解症状的应对策略及饮食体验
Qual Health Res. 2021 Jan;31(2):361-372. doi: 10.1177/1049732320967908. Epub 2020 Nov 4.
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Diagnosis and treatment of gastrointestinal disorders in patients with primary immunodeficiency.原发性免疫缺陷病患者的胃肠疾病的诊断与治疗。
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Arthritis Res Ther. 2012 Sep 24;14(5):223. doi: 10.1186/ar4032.
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Review of gastric cancer risk factors in patients with common variable immunodeficiency disorders, resulting in a proposal for a surveillance programme.常见可变免疫缺陷疾病患者胃癌风险因素的综述，提出了一项监测计划建议。
Clin Exp Immunol. 2011 Jul;165(1):1-7. doi: 10.1111/j.1365-2249.2011.04384.x. Epub 2011 Apr 6.
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