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Despite being one of the most frequent causes of immunodeficiency, involving gastrointestinal (GI), respiratory, and hematological systems, the disease onset can have heterogeneous and intermittent symptoms, frequently leading to diagnostic delay. GI symptoms are common and can include diarrhea, but the asymptomatic periods lead to overlooking the recurrent pattern. The same can occur with respiratory infections, thus delaying CVID suspicion. The starting point for CVID diagnosis is the decreased gamma globulin levels in serum protein electrophoresis (SPE), also observed through direct immunoglobulin\u2019s dosage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The patient is a 38\u00a0years-old man who had intermittent diarrhea and recurrent airway infections for 19\u00a0years, but the CVID diagnosis was achieved only after SPE was carried out. At that time, he was already malnourished, and developed other complications related to CVID in a short period.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>SPE is readily available and inexpensive, but is not part of the laboratory approach in diarrhea. According to the case presented herein, it can be useful for patients with recurrent infections or other clues of the disease.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02477-6","type":"journal-article","created":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T04:02:41Z","timestamp":1662264161000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Are we forgetting to carry out serum protein electrophoresis as part of diagnosis workup?"],"prefix":"10.1186","volume":"22","author":[{"given":"Mariana Barros","family":"Marcondes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00edntia Mitsue Pereira","family":"Susuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Newton Key","family":"Hokama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula de Oliveira Montandon","family":"Hokama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Aguera","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Sergio","family":"Chaib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingshun","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-6895","authenticated-orcid":false,"given":"Fernando Gomes","family":"Romeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"key":"2477_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60872-7","author":"A Schieppati","year":"2008","unstructured":"Schieppati A, Henter JI, Daina E, Aperia A. 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