Chronic enteropathy-related malabsorption syndrome in an adult with common variable immunodeficiency and symptomatic norovirus infection of the gut. Issue 5 (20th May 2021)

• Record Type: Journal Article
• Authors: Jain, Punit; Mishra, Anand; Gupta, Deepakkumar; Kulkarni, Satish
• Is Part Of: BMJ case reports. Volume 14:Issue 5(2021)
• Publication Date: 2021-05-20
• Subjects: malignant and benign haematology -- immunology -- infectious diseases; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-241752
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Common variable immunodeficiency (CVID) causes a chronic debilitating syndrome in affected patients and often leads to high morbidity and mortality. Among its several presentations, chronic enteropathy leading to malabsorption syndrome continues to offer a major diagnostic dilemma. Lately, higher testing for norovirus infection in patients with CVID enteropathy has correlated its presence to chronic diarrhoeas, severe villous atrophy and malabsorption syndromes. There have been no such reports of its clinical and histopathological manifestations in CVID from India. Here, we demonstrate the significance of testing for norovirus in the gut with multiplex PCRs in an adult patient with a chronic undiagnosed CVID enteropathy and its response to monthly intravenous immunoglobulin (IVIG) therapy. Our patient responded after three cycles of monthly IVIG with a complete clinical recovery of his bowel functions, leading to a significant improvement in his quality of life and performance status.