Gastrointestinal Manifestations in Patients with Agammaglobulinemia

Introduction: The most frequent symptoms of agammaglobulinemia are recurrent respiratory and gastrointestinal problems. The purpose of this study was to define the prevalence and type of gastrointestinal (GI) manifestations in those patients with agammaglobulinemia. Methods: totally, 147 patients with agammaglobulinemia were included in this study. For each patient, clinical, immunological and laboratory data were documented. Results: The GI manifestations as the first presentation of the immunodeficiency diseases were reported in 14.5% of patients, mostly because of chronic and recurrent diarrhea. History of GI manifestations was evident in 67 patients (45.6%). Recurrent, chronic or bloody diarrhea (36.1%), vomiting (10.2%) and gastroenteritis (6.1%) were the most common manifestations of GI in patients with agammaglobulinemia, respectively. Conclusions: The bowel is exposed to multiple antigens including gut microbiota and pathogens from the environment. Mucosal antibodies play a major role in protection and homeostasis; therefore, decreasing level of IgA can provide the opportunity for infectious diarrhea and more pathogen to attack.