{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:25:14Z","timestamp":1792081514705,"version":"4.4.0"},"reference-count":60,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Gastrointestinal diseases are a major cause of morbidity in common variable immunodeficiency disorder (CVID), clinically often mimicking other conditions including celiac disease and inflammatory bowel disease (IBD). Hence, diagnosis of CVID remains challenging. This study aims to raise awareness and highlight histopathological clues for CVID in intestinal biopsies, emphasizing diagnostic pitfalls for the pathologist\/gastroenterologist. Methods: We reviewed 63 (18 duodenal, 23 ileal, 22 colonic) biopsies and case histories from seven CVID patients, obtained over a 31-year period, with attention to active inflammation, intraepithelial lymphocytes, plasma cells, lymphoid hyperplasia, crypt\/villous architecture, subepithelial collagen, apoptosis, granulomas, and infections. Clinical information of 41 pathology requests was reviewed. Results: Gastrointestinal symptoms were variable. Histological features included IBD-like (3\/7), celiac disease-like (2\/7), graft-versus-host disease (GVHD)-like (2\/7), lymphocytic sprue\/colitis-like (3\/7), collagenous colitis-like (2\/7), and acute colitis-like (4\/7) patterns, often overlapping (2\/7) and\/or changing over time (3\/7). Lymphoid hyperplasia was seen in 3\/7 patients; 1\/7 had giardiasis; and 5\/7 had few plasma cells, usually only in part of the gut (3\/5). Clinical information of 12\/41 (29%) pathology requests mentioned known\/suspected CVID, despite being known in 33\/41 (80%). Conclusions: Clinical\/histological features of CVID in the gut are diverse, often mimicking IBD, microscopic colitis, celiac disease and\/or GVHD, hence the importance of adequate clinical information. Some histological features are atypical of these established entities and may indicate CVID, as may overlapping\/changing histological patterns and\/or few plasma cells in part of the gut. Awareness of the heterogenous clinical presentation and histopathological indicators of CVID may improve diagnosis.<\/jats:p>","DOI":"10.3390\/jcm14020497","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T07:35:47Z","timestamp":1736840147000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Gastrointestinal Disease in Common Variable Immunodeficiency Disorder (CVID): Histological Patterns, Diagnostic Clues and Pitfalls for the Pathologist and Gastroenterologist"],"prefix":"10.3390","volume":"14","author":[{"given":"Lars","family":"Velthof","sequence":"first","affiliation":[{"name":"Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-2929","authenticated-orcid":false,"given":"Jeroen","family":"Geldof","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-4319","authenticated-orcid":false,"given":"Marie","family":"Truyens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"},{"name":"IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8175-2930","authenticated-orcid":false,"given":"Jo","family":"Van Dorpe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"},{"name":"Cancer Research Institute Ghent (CRIG), Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4030-761X","authenticated-orcid":false,"given":"Liesbeth","family":"Ferdinande","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"},{"name":"Cancer Research Institute Ghent (CRIG), Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5213-5391","authenticated-orcid":false,"given":"Ciel","family":"De Vriendt","sequence":"additional","affiliation":[{"name":"Department of Hematology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Kerre","sequence":"additional","affiliation":[{"name":"Department of Hematology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomeen","family":"Haerynck","sequence":"additional","affiliation":[{"name":"PID Research Laboratory, Department of Pediatric Immunology and Pulmonology, Centre for Primary Immunodeficiency Ghent (CPIG), Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-7704","authenticated-orcid":false,"given":"Triana","family":"Lobat\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0736-2034","authenticated-orcid":false,"given":"Anne","family":"Hoorens","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2977","DOI":"10.1007\/s10620-006-9736-6","article-title":"Gastrointestinal Manifestations in Patients with Common Variable Immunodeficiency","volume":"52","author":"Khodadad","year":"2007","journal-title":"Dig. 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