TBA (16S153)

GI Manifestations of CVID- Scope for Change?

Author(s)

Judge C., Lee-Brennan C., Sloan A., McKeever A., McCrea P., Kevans D., Conlon N.

Department(s)/Institutions

St James's Hospital, Immunology, Dublin, Ireland

Introduction

Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder affecting approximately 1 in 50,000 adults and children. CVID is characterised by a failure in the production of adequate immunoglobulins, the absence of an effective vaccine response and, in some cases, immune dysregulation. This results in frequent bacterial infections and pathology affecting multiple organ systems. Gastrointestinal disease affects 15-20% of people with CVID and has many different manifestations, including higher incidences of Giardia lamblia infection, inflammatory bowel disease and GI malignancy.

Aims/Background

We aimed to evaluate the prevalence of GI involvement in CVID patients in a single Republic of Ireland centre, and to identify the need for a standardised diagnostic approach to these patients.

Method

We retrospectively analysed the charts and electronic records of all patients diagnosed with CVID who attended the Immunology Department of St James's Hospital, Dublin. We recorded documentation of GI symptoms or signs found in clinical notes and patient correspondence, as well as any investigations pertaining to GI disease available on the Electronic Patient Record (EPR).

Results

24 patient records were analysed, of which the majority were female (54.2%) and the median age was 44.7 years. 66.7% of patients had at least one documented GI symptom. Diarrhoea was the most common complaint, affecting 62.5% of patients. 20.8% of patients complained of pain or constipation, and 12.5% reported PR bleeding. 16.6% of patients had faecal testing for evidence of infection, with 50% found to be positive (Campylobacter, Giardia). 54.2% of patients underwent endoscopy with a variety of histological results. These included lymphocytic gastritis, colitis, tubular adenoma and nodular lymphoid hyperplasia. None of the patients had either faecal calprotectin testing, or urea breath testing.