PMID- 22904128
OWN - NLM
STAT- MEDLINE
DCOM- 20121029
LR  - 20120820
IS  - 1943-7722 (Electronic)
IS  - 0002-9173 (Linking)
VI  - 138
IP  - 2
DP  - 2012 Aug
TI  - The significance of duodenal mucosal atrophy in patients with common variable 
      immunodeficiency: a clinical and histopathologic study.
PG  - 185-9
LID - 10.1309/AJCPEIILH2C0WFYE [doi]
AB  - Gastrointestinal manifestations and villous atrophy can be seen in patients with 
      common variable immunodeficiency (CVID). In some patients, infectious agents may 
      be responsible, whereas in others, celiac disease (CD) may be the cause. In this 
      study, we investigate the causes and the histopathologic features seen in 
      patients with CVID. Eleven patients with CVID and villous atrophy underwent 
      duodenal biopsies, human leukocyte antigen (HLA) typing, and testing for all 
      celiac antibodies. Fifteen patients with CVID and normal villi and 6 patients 
      with CD but without CVID served as controls. Histologic response to a gluten-free 
      diet (GFD) allowed a diagnosis of CD in 3 of 11 patients. In the remaining 8, the 
      lack of a histologic response to a GFD or HLA typing excluded CD. Celiac 
      antibodies gave conflicting results and were of no help. Polymorphonuclear 
      infiltrates and lesions like graft-versus-host disease are seen more often in 
      flat mucosa unresponsive to a GFD. However, the specificity of these findings 
      remains to be determined and response to a GFD remains the only diagnostic 
      criteria for CD in these patients. Villous atrophy was gluten-sensitive in 3 of 
      11 patients with CVID. It was not related to gluten-responsive CD in most 
      patients.
FAU - Biagi, Federico
AU  - Biagi F
AD  - Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS 
      Policlinico San Matteo, Pavia, Italy. f.biagi@smatteo.pv.it
FAU - Bianchi, Paola I
AU  - Bianchi PI
FAU - Zilli, Alessandra
AU  - Zilli A
FAU - Marchese, Alessandra
AU  - Marchese A
FAU - Luinetti, Ombretta
AU  - Luinetti O
FAU - Lougaris, Vassilios
AU  - Lougaris V
FAU - Plebani, Alessandro
AU  - Plebani A
FAU - Villanacci, Vincenzo
AU  - Villanacci V
FAU - Corazza, Gino R
AU  - Corazza GR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Am J Clin Pathol
JT  - American journal of clinical pathology
JID - 0370470
SB  - IM
MH  - Adult
MH  - Atrophy/pathology
MH  - Biopsy
MH  - Celiac Disease/complications/*pathology
MH  - Common Variable Immunodeficiency/complications/*pathology
MH  - Duodenum/*pathology
MH  - Female
MH  - Graft vs Host Disease/complications/pathology
MH  - Humans
MH  - Intestinal Mucosa/*pathology
MH  - Male
MH  - Neutrophils/pathology
MH  - Plasma Cells/pathology
EDAT- 2012/08/21 06:00
MHDA- 2012/10/30 06:00
CRDT- 2012/08/21 06:00
PHST- 2012/08/21 06:00 [entrez]
PHST- 2012/08/21 06:00 [pubmed]
PHST- 2012/10/30 06:00 [medline]
AID - 138/2/185 [pii]
AID - 10.1309/AJCPEIILH2C0WFYE [doi]
PST - ppublish
SO  - Am J Clin Pathol. 2012 Aug;138(2):185-9. doi: 10.1309/AJCPEIILH2C0WFYE.