Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency
Metadatos
Mostrar el registro completo del ítemAutor
Díaz Alberola, Irene; Gutiérrez Bautista, Juan Francisco; Anderson, Per Olof; Jiménez, Pilar; Hidalgo Tenorio, Carmen; López Nevot, Miguel ÁngelEditorial
MDPI
Materia
CVID Immunodeficiency Gastrointestinal infections Giardia Giardiasis Refractory Treatment Immunology Immunogenetic
Fecha
2022-11-27Referencia bibliográfica
Díaz-Alberola, I... [et al.]. Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency. J. Clin. Med. 2022, 11, 7007. [https://doi.org/10.3390/jcm11237007]
Resumen
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 decisionmaking
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.