Human immunodeficiency virus infection mimicking very early onset inflammatory bowel disease

What To Know

A 4‑year‑old with poor weight gain, intermittent diarrhea, high fecal calprotectin, and endoscopic colitis was treated for VEO‑IBD with mesalamine and multiple biologic/small‑molecule therapies without full response.

Progressive lymphopenia and later presentation with fever, cytopenias, Pneumocystis jirovecii pneumonia, and CMV viremia prompted HIV testing, which was positive. After stopping immunosuppressants and initiating ART, GI symptoms and inflammatory markers improved.

This report highlights that infectious causes, including HIV‑associated colitis, can mimic VEO‑IBD and that unexplained lymphopenia or atypical infections should trigger evaluation for secondary immunodeficiency. The article is an abstracted case report (JPGN Reports); it summarizes a single patient’s course rather than presenting trial data.