Gastrointestinal manifestations of Iranian patients with LRBA deficiency

Background: Lipopolysaccharide-responsive beige-like anchor protein (LRBA) deficiency is a rare genetic primary immunodeficiency (PID) disease caused by mutation in the LRBA gene. The most important symptoms in patients include autoimmunity, recurrent infections, hypogammaglobulinemia, and enteropathy. Methods: A total of 19 LRBA patients were enrolled in this longitudinal study. All recorded data for clinical presentation, demographic information, laboratory and gastrointestinal findings were collected. Results: In this study, 11 females and 8 males (from 16 unrelated families) with LRBA deficiency were evaluated. The most common gastrointestinal symptoms were gastroenteritis, chronic or bloody diarrhea with abdominal pain, vomiting, anorexia, and FTT. The most important pathologic finding was colitis that was seen in 4 patients. Gastritis, esophagitis, gastroesophageal reflux disease, celiac-like disease, and normal upper endoscopy were documented equally in 2 patients. Also seen was enteritis in 3, proctitis, ileitis, and cryptitis in 1, and villous atrophy in 3 of the LRBA patients. Conclusion: A variety of gastrointestinal conditions may be the most frequent complications in patients with LRBA deficiency.