{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:08:40Z","timestamp":1779916120447,"version":"3.53.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2004,7,23]],"date-time":"2004-07-23T00:00:00Z","timestamp":1090540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,7,23]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Common variable immunodeficiency (CVID) is a heterogeneous immunodeficiency that is accompanied by granulomatous lesions in 5\u201310% of cases. Why some patients develop granulomatous disease remains unclear. Here we describe a 12-year-old previously healthy girl who presented with pancytopenia and granulomatous lymphoproliferation subsequent to infection with Toxoplasma gondii. Loosely arranged non-fibrosing granulomas were observed in the liver, lymph nodes and lung, but no Toxoplasma tachyzoites could be demonstrated and polymerase chain reaction (PCR) and culture were negative for Toxoplasma and a wide range of other pathogens. While the patient had a normal peripheral B cell status at presentation, the development of CVID could be observed during the following months, leading to a loss of memory B cells. This was accompanied by an increasingly activated CD4+ T cell compartment and high serum levels of angiotensin-converting enzyme (ACE), tumour necrosis factor (TNF) and sCD25. Steroid therapy reduced pancytopenia, granulomatous lymphoproliferation and cytokine elevations, but did not improve the B cell status. This is the first report of an association of Toxoplasma infection with granulomatous CVID and provides one of the rare examples where the onset of CVID could be documented subsequent to an infectious disease.<\/jats:p>","DOI":"10.1111\/j.1365-2249.2004.02558.x","type":"journal-article","created":{"date-parts":[[2004,8,20]],"date-time":"2004-08-20T10:57:27Z","timestamp":1092999447000},"page":"578-583","source":"Crossref","is-referenced-by-count":25,"title":["Development of granulomatous common variable immunodeficiency subsequent to infection with<i>Toxoplasma gondii<\/i>"],"prefix":"10.1093","volume":"137","author":[{"given":"S","family":"MRUSEK","sequence":"first","affiliation":[{"name":"Center for Pediatric and Adolescent Medicine, University of Freiburg, Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"MARX","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of W\u00fcrzburg, W\u00fcrzburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"K\u00dcMMERLE-DESCHNER","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of T\u00fcbingen, T\u00fcbingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"TZARIBACHEV","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of T\u00fcbingen, T\u00fcbingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"ENDERS","sequence":"additional","affiliation":[{"name":"Center for Pediatric and Adolescent Medicine, University of Freiburg, Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U-N","family":"RIEDE","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Ludwig-Aschoff-Haus, Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"WARNATZ","sequence":"additional","affiliation":[{"name":"Medical University Clinic, Department of Rheumatology and Clinical Immunology, Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G E","family":"DANNECKER","sequence":"additional","affiliation":[{"name":"Olgahospital, Department of Pediatics and Pediatric Rheumatology, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"EHL","sequence":"additional","affiliation":[{"name":"Center for Pediatric and Adolescent Medicine, University of Freiburg, Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,7,23]]},"reference":[{"key":"2022011223190970300_b1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/S0952-7915(00)00256-9","article-title":"Human genetic defects in class-switch recombination (hyper-IgM syndromes)","volume":"13","author":"Durandy","year":"2001","journal-title":"Curr Opin Immunol"},{"key":"2022011223190970300_b2","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1182\/blood.V98.5.1321","article-title":"Alterations of the X-linked lymphoproliferative disease gene SH2D1A in common variable immunodeficiency syndrome","volume":"98","author":"Morra","year":"2001","journal-title":"Blood"},{"key":"2022011223190970300_b3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/ni902","article-title":"Homozygous loss of ICOS is associated with adult-onset common variable immunodeficiency","volume":"4","author":"Grimbacher","year":"2003","journal-title":"Nat Immunol"},{"key":"2022011223190970300_b4","doi-asserted-by":"crossref","first-page":"4408","DOI":"10.4049\/jimmunol.164.8.4408","article-title":"Fine mapping of IGAD1 in IgA deficiency and common variable immunodeficiency: identification and characterization of haplotypes shared by affected members of 101 multiple-case families","volume":"164","author":"Vorechovsky","year":"2000","journal-title":"J Immunol"},{"key":"2022011223190970300_b5","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0167-5699(97)01086-4","article-title":"Common variable immunodeficiency: how many diseases?","volume":"18","author":"Spickett","year":"1997","journal-title":"Immunol Today"},{"key":"2022011223190970300_b6","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1007\/s00431-002-1083-9","article-title":"Mutations of the X-linked lymphoproliferative disease gene SH2D1A mimicking common variable immunodeficiency","volume":"161","author":"Soresina","year":"2002","journal-title":"Eur J Pediatr"},{"key":"2022011223190970300_b7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00005792-199609000-00002","article-title":"Sarcoidosis and common variable immunodeficiency. 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