常见可变免疫缺陷综合征的广泛肝脏表现——两例报告及文献综述
A Broad Spectrum of Liver Manifestations in Common Variable Immunodeficiency Syndrome-Two Case Reports and a Literature Overview.
作者信息
Supovec Eva, Drnovšek Jan
机构信息
Department of Gastroenterology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
出版信息
Diagnostics (Basel). 2025 Jun 29;15(13):1659. doi: 10.3390/diagnostics15131659.
Common variable immunodeficiency (CVID) is a primary B-cell immunodeficiency disorder, characterized by severe hypogammaglobulinemia and disturbed antibody production. In addition to increased susceptibility to recurrent respiratory and gastrointestinal infections, CVID can lead to a wide array of complications associated with immune dysregulation, which can also affect the liver. Liver involvement occurs in about 10% of patients with CVID, and can result from a range of causes, including infections, autoimmune disorders, lymphoproliferative conditions, granulomatous inflammation, and infiltrative processes. The most common liver manifestations include nodular regenerative hyperplasia, granulomatous or autoimmune hepatitis, and lymphocytic infiltration. The prevalence, pathophysiology, extent, and prognosis of liver involvement in CVID have not been systematically studied. The object of this article is to present two patients with CVID-related liver disease and to illuminate the most relevant causes of liver involvement in CVID, describe the clinical features of their liver disease, and summarize the diagnostic and therapeutic approaches for its management. Liver involvement is an expected complication in patients with CVID syndrome. The delayed recognition of this pathology significantly worsens the disease prognosis, making the early detection of this potential complication crucial.
普通可变型免疫缺陷(CVID)是一种原发性B细胞免疫缺陷疾病,其特征为严重低丙种球蛋白血症和抗体产生紊乱。除了反复发生呼吸道和胃肠道感染的易感性增加外,CVID还可导致一系列与免疫失调相关的并发症,这也会影响肝脏。约10%的CVID患者会出现肝脏受累,其病因多种多样,包括感染、自身免疫性疾病、淋巴增殖性疾病、肉芽肿性炎症和浸润性病变。最常见的肝脏表现包括结节性再生性增生、肉芽肿性或自身免疫性肝炎以及淋巴细胞浸润。CVID患者肝脏受累的患病率、病理生理学、程度和预后尚未得到系统研究。本文的目的是介绍两名患有CVID相关肝病的患者,阐明CVID患者肝脏受累的最相关病因,描述其肝病的临床特征,并总结其诊断和治疗方法。肝脏受累是CVID综合征患者的一种预期并发症。对这种病理状况的延迟识别会显著恶化疾病预后,因此早期发现这种潜在并发症至关重要。