Conclusion

Patients with primary immunodeficiencies often have GI manifestations. Therefore, in patients with recurrent giardiasis, celiac disease, NLH, and IBD, screening for CVID or IgA deficiency (plus IgG2 subclass deficiency) with serum Ig levels should be considered. Although treatment of inflammatory conditions with immunomodulators, such as azathioprine and 6-MP, does not lead to increased complications when given concurrently with IVIG, chronic oral steroid use in immunocompromised patients should be undertaken with extreme care. Given the increased risk of GI malignancy in CVID, periodic GI screening is warranted.

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