Background: Common variable immunodeficiency (CVID) encompasses a heterogeneous
group of primary antibody deficiency disorders characterized by recurrent infections, autoimmunity
and malignancies. Gastrointestinal manifestations are frequently associated with CVID.
Objective: In this cross-sectional study, we evaluated gastric and duodenal involvement in a cohort of
adult patients with CVID.
Methods: Upper gastrointestinal endoscopy was performed in 58 patients (26 males, mean age 47.8±15.6
years), diagnosed with CVID according to 2014 ESID criteria. Random biopsies were collected from gastric
antrum and descending duodenum for the all enrolled subjects. Intraepithelial lymphocytosis in descending
duodenum was defined as the presence of 25 lymphocytes per 100 enterocytes.
Results: The major histopathological findings that we found were: a) chronic active gastritis (44.8%),
Helicobacter pylori-associated (8.6%), b) chronic duodenitis (39.6%) with intraepithelial lymphocytosis
(31%) and absence of plasma cells (18.9%) and c) autoimmune atrophic gastritis (5.2%). Three patients
(5.2%) presented Intestinal Metaplasia (IM) of the gastric antrum. This finding was associated
with H. pylori infection and persisted after the eradication in one patient. IM was associated with autoimmune
atrophic gastritis in two cases. Giardia lamblia infection was observed in the duodenum samples
from three patients (5.2%). A diagnosis of Gastric adenocarcinoma was made in a 58-year- old
woman diagnosed with gastric dysplasia one year earlier.
Conclusion: In our cohort of CVID patients, gastro-duodenal histopathological findings, including malignancies,
are frequent and can affect long-term prognosis. A rigorous endoscopic follow-up is needed
in CVID patients irrespective of the gastrointestinal symptoms.