Malabsorption Due to Chronic Giardiasis as a Presenting Symptom of Common Variable Immunodeficiency

Sousa, Débora; Gonçalves, Tiago Neto; Marto, Natália; Horta, Alexandra Bayão

doi:10.7759/cureus.12201

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Acquired lactose intolerance occurs in up to 40 percent of patients; clinically, this manifests with exacerbation in intestinal symptoms following ingestion of dairy products. Recovery can take many weeks, even after clearance of the parasite [103,104].…”

Section: Infectiousmentioning

confidence: 99%

Small and Large Intestine (I): Malabsorption of Nutrients

2021

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Numerous disorders can alter the physiological mechanisms that guarantee proper digestion and absorption of nutrients (macro- and micronutrients), leading to a wide variety of symptoms and nutritional consequences. Malabsorption can be caused by many diseases of the small intestine, as well as by diseases of the pancreas, liver, biliary tract, and stomach. This article provides an overview of pathophysiologic mechanisms that lead to symptoms or complications of maldigestion (defined as the defective intraluminal hydrolysis of nutrients) or malabsorption (defined as defective mucosal absorption), as well as its clinical consequences, including both gastrointestinal symptoms and extraintestinal manifestations and/or laboratory abnormalities. The normal uptake of nutrients, vitamins, and minerals by the gastrointestinal tract (GI) requires several steps, each of which can be compromised in disease. This article will first describe the mechanisms that lead to poor assimilation of nutrients, and secondly discuss the symptoms and nutritional consequences of each specific disorder. The clinician must be aware that many malabsorptive disorders are manifested by subtle disorders, even without gastrointestinal symptoms (for example, anemia, osteoporosis, or infertility in celiac disease), so the index of suspicion must be high to recognize the underlying diseases in time.

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Section: Infectiousmentioning

confidence: 99%

Small and Large Intestine (I): Malabsorption of Nutrients

2021

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Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency

Díaz-Alberola

Gutiérrez‐Bautista

Espuch-Oliver

et al. 2022

JCM

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Common variable immunodeficiency (CVID) is an antibody immunodeficiency with a wide variety of clinical and immunological manifestations, and whose genetic cause is found in about 25% of diagnosed cases. Giardia lamblia is one of the main causes of gastrointestinal infections in CVID. 5-Nitroimidazoles are the most used first-line treatment, but nitroimidazole-refractory giardiasis is increasing. Nevertheless, only a few cases of refractory giardiasis in CVID have been reported. This study aimed to determine the incidence of Giardia infection in our CVID cohort, shows our management experience and describes patients’ phenotypic features. Clinical data collection, immunological, immunogenetics and microbiology assays were performed, and previous cases of giardiasis in CVID were reviewed. The incidence of symptomatic giardiasis was 12.9%. The main immunological features were undetectable or decreased IgA levels and reduced switched memory B cells. A probable PTEN pathogenic variant was detected in one. Three patients responded to metronidazole but suffered reinfections, and one was a refractory giardiasis eradicated with innovative quinacrine plus paromomycin combination. This work could contribute to the decision-making and therapeutic management of future patients with CVID and giardiasis, highlighting the importance of the early detection and treatment of infections in patients with CVID to ensure a good quality of life.

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Malabsorption Due to Chronic Giardiasis as a Presenting Symptom of Common Variable Immunodeficiency

Cited by 2 publications

References 5 publications

Small and Large Intestine (I): Malabsorption of Nutrients

Small and Large Intestine (I): Malabsorption of Nutrients

Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency

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