Gastrointestinal manifestations of common variable immunodeficiency: what a gastroenterologist needs to be aware of.

What To Know

This review summarizes gastrointestinal and hepatic features of common variable immunodeficiency (CVID) that gastroenterologists should recognize. It covers clinical presentations, endoscopic and imaging findings, pathology, and diagnostic and treatment challenges — including how CVID can mimic celiac disease, Crohn’s disease, and ulcerative colitis.

The article highlights several GI problems seen in CVID: increased susceptibility to enteric infections, chronic gastritis, an enteropathy that can resemble celiac disease, and an IBD-like inflammatory bowel disease. It also notes liver involvement and a higher prevalence of gastrointestinal cancers in people with CVID.

Clinically, the review emphasizes the difficulty of differentiating CVID-related GI disease from primary IBD and other causes, and the need for targeted diagnostic testing (endoscopy with biopsy, imaging, and relevant laboratory evaluation) and tailored management.

If you care for patients with atypical IBD features, recurrent infections, poor response to standard therapies, or extraintestinal findings, consider whether underlying immunodeficiency (like CVID) might explain the presentation and prompt referral to immunology.