Common variable immunodeficiency
Common variable immunodeficiency, abbreviated CVID, is a group of genetic disorders characterized by deficient antibody production.
General
Features:[1]
- Recurrent sinus and pulmonary infections.
- Inflammatory bowel disease-like disease.
Gross
Duodenum:
- Nodular mucosa - due to lymphoid hyperplasia.
Microscopic
Features - general:
- Plasma cells absent (or reduced) - key feature.[1]
- +/-Lymphoid aggregates.
DDx:
Esophagus
Features - esophagus:[2]
- Intraepithelial PMNs & candida.
- +/-Abundant intraepithelial lymphocytes.
Stomach
Features - stomach:[2]
- Lack of plasma cells ~ 2/3 of individuals - key feature
- Lymphoid aggregates - common.
- +/-Lymphocytic gastritis.
- +/-Intraepithelial neutrophils.
- +/-Infections (CMV, H. pylori, cryptosporidium).
Small bowel
Features - small bowel:[2]
- Villous blunting > 80% of individuals.
- Decreased plasma cells ~ 2/3 of individuals - key feature.
- Lymphoid aggregates ~ 1/2 of individuals.
- +/-Neutrophils + infections (CMV, cryptosporidium).
Large bowel
Features:[2]
- Decreased plasma cells - key feature.
- Lymphoid aggregates.
- +/-Apparent apoptosis.
See also
References
- ↑ 1.0 1.1 Agarwal S, Smereka P, Harpaz N, Cunningham-Rundles C, Mayer L (July 2010). "Characterization of immunologic defects in patients with common variable immunodeficiency (CVID) with intestinal disease". Inflamm Bowel Dis. doi:10.1002/ibd.21376. PMID 20629103.
- ↑ 2.0 2.1 2.2 2.3 Daniels, JA.; Lederman, HM.; Maitra, A.; Montgomery, EA. (Dec 2007). "Gastrointestinal tract pathology in patients with common variable immunodeficiency (CVID): a clinicopathologic study and review.". Am J Surg Pathol 31 (12): 1800-12. doi:10.1097/PAS.0b013e3180cab60c. PMID 18043034.