Common Variable Immunodeficiency Enteropathy With Chronic Giardiasis

A 61-year-old man from Georgia, with common variable immunodeficiency (CVID), presented with generalized weakness, multiple diarrheal episodes day and night, and 120-lb weight loss over 4 years in the context of chronic giardiasis refractory to multiple treatments with metronidazole. He was deficient in vitamins A, D, and K, as well as iron and zinc. Magnetic resonance imaging of his abdomen showed small-bowel thickening, dilated portal vein, and splenomegaly characteristic of CVID (Figure  1). Upper endoscopy revealed diffusely thickened duodenal folds (Supplemental Figure, available online at http://www.mayoclinicproceedings.org).
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research