Crohn's-like disease in a patient with common variable immunodeficiency treated with azathioprine and adalimumab.

Common variable immunodeficiency (CVID) is the most frequent primary antibody deficiency. It is characterized by recurrent bacterial infections, and occurrence of autoimmune and neoplastic diseases is also frequent; there is also a high prevalence of gastrointestinal diseases. There are reports of inflammatory bowel disease in this entity, but incidence is low (2-4 %). We present the case of a patient with common variable immunodeficiency suffering a chronic diarrhea episode and who was diagnosed with ileocaecal Crohn s-like disease after performing intestinal transit, CT abdomen and colonoscopy with biopsy. It was first treated with prednisone but on showing cortisone dependency, treatment with azathioprine and adalimumab was started, with good results.

[1]  C. Cunningham-Rundles,et al.  Common variable immunodeficiency. , 2012, The Journal of allergy and clinical immunology.

[2]  James T.C. Li,et al.  Common variable immunodeficiency: a new look at an old disease , 2008, The Lancet.

[3]  E. Montgomery,et al.  Gastrointestinal Tract Pathology in Patients With Common Variable Immunodeficiency (CVID): A Clinicopathologic Study and Review , 2007, The American journal of surgical pathology.

[4]  W. Chey,et al.  Successful Treatment of Common Variable Immunodeficiency Disorder-Associated Diarrhea With Budesonide: A Case Report , 2007, The American Journal of Gastroenterology.

[5]  A. Salavati,et al.  Gastrointestinal Manifestations in Patients with Common Variable Immunodeficiency , 2007, Digestive Diseases and Sciences.

[6]  A. Plebani,et al.  Long-Term Follow-Up and Outcome of a Large Cohort of Patients with Common Variable Immunodeficiency , 2007, Journal of Clinical Immunology.

[7]  P. Nos,et al.  Crohn's Disease in Common Variable Immunodeficiency: Treatment with Antitumor Necrosis Factor Alpha , 2006, The American Journal of Gastroenterology.

[8]  R. Kiesslich,et al.  Crohn’s-like Colitis in a Patient with Immunodeficiency Associated with a Defect in Expression of Inducible Costimulator , 2006, Digestive Diseases and Sciences.

[9]  B. Bosworth,et al.  Common variable immunodeficiency masquerading as Crohn's ileocolitis. , 2006, Inflammatory bowel diseases.

[10]  C. Cunningham-Rundles,et al.  Common variable immunodeficiency: clinical and immunological features of 248 patients. , 1999, Clinical immunology.

[11]  S. Frøland,et al.  Persistent activation of the tumor necrosis factor system in a subgroup of patients with common variable immunodeficiency--possible immunologic and clinical consequences. , 1996, Blood.

[12]  J. Carbone,et al.  [Autoimmune disease in primary antibody deficiencies]. , 2005, Allergologia et immunopathologia.

[13]  R. Hermaszewski,et al.  Primary hypogammaglobulinaemia: a survey of clinical manifestations and complications. , 1993, The Quarterly journal of medicine.