Abstract

VAZ, Ana Sofia Geraldes et al. Cytomegalovirus gastritis and ileitis as presentation of common variable immunodeficiency in an adolescente. Rev Port Imunoalergologia [online]. 2019, vol.27, n.4, pp.327-334. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2020.01.025.

Objective: To describe the case of a common variable immunodeficiency (CVID) whose first manifestation was chronic diarrhea due to cytomegalovirus (CMV) gastrointestinal infection. This is a rare and underdiagnosed presentation, whose early diagnosis and intervention may prevent the morbidity and mortality associated with this infection. Case description: 16 year-oldmale adolescent with chronic diarrhea from the age of 10 years and body weight loss in the last 2 years, with norelevant past clinical history, referred to our consultation with diagnostic criteria for CVID (low levels of immunoglobulin (Ig) G, A and M; absence of anti-mumps and anti-hepatitisB surface antibodies; excluded other causes of hypogammaglobulinemia).After intravenous Ig replacement was initiated, diarrhea persisted, which led to perform high endoscopy and colonoscopy.Biopsy immunohistochemical analysis revealed CMV gastritis and ileitis. After intravenous ganciclovir therapeutic, clinicalresolution was achieved. Discussion: CMV infection should be investigated in patients with CVID and chronic diarrhea simultaneously with the exclusion of more common gastrointestinal diseases such as Giardia lamblia infection, coeliac disease and inflammatory bowel disease.

Keywords : Cytomegalovirus; common variable immunodeficiency; diarrhoea.

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