Furtado AK, Cabral VLR, Santos TN, Mansour E, Nagasako CK, Lorena SL, Pereira-Filho RA. Giardia infection: Protein-losing enteropathy in an adult with immunodeficiency. World J Gastroenterol 2012; 18(19): 2430-2433 [PMID: 22654437 DOI: 10.3748/wjg.v18.i19.2430]
Corresponding Author of This Article
Alexandre Khodr Furtado, MD, Faculdade de Ciências Médicas, Universidade de Campinas-Unicamp, Rua Tessália Vieira de Camargo, 126, Cidade Universitária “Zeferino Vaz”, 13083-887 Campinas, Brazil. alexandrekhodr@gmail.com
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Alexandre Khodr Furtado, Virginia Lucia Ribeiro Cabral, Thiago Nunes Santos, Eli Mansour, Cristiane Kibune Nagasako, Sonia Leticia Lorena, Rogerio Antunes Pereira-Filho, Faculdade de Ciências Médicas, Universidade de Campinas-Unicamp, Rua Tessália Vieira de Camargo, 126, Cidade Universitária “Zeferino Vaz”, 13083-887 Campinas, Brazil
Author contributions: Furtado AK and Cabral VLR made substantial contributions to study conception and design, drafted the article and revised it critically for important intellectual content; Santos TN analyzed the data; Mansour E, Nagasako CK, Lorena SL and Pereira-Filho RA contributed to collecting patients, endoscopic procedures, the acquisition of data and analysis and interpretation; all authors approved the version to be published.
Correspondence to: Alexandre Khodr Furtado, MD, Faculdade de Ciências Médicas, Universidade de Campinas-Unicamp, Rua Tessália Vieira de Camargo, 126, Cidade Universitária “Zeferino Vaz”, 13083-887 Campinas, Brazil. alexandrekhodr@gmail.com
Telephone: +55-19-35218545 Fax: +55-19-35218540
Received: June 25, 2011 Revised: September 23, 2011 Accepted: April 12, 2012 Published online: May 21, 2012
Abstract
The case of a 52-year-old woman with a past history of thymoma resection who presented with chronic diarrhea and generalized edema is the focal point of this article. A diagnosis of Giardia lamblia infection was established, which was complicated by protein-losing enteropathy and severely low serum protein level in a patient with no urinary protein loss and normal liver function. After anti-helmintic treatment, there was recovery from hypoalbuminemia, though immunoglobulins persisted at low serum levels leading to the hypothesis of an immune system disorder. Good’s syndrome is a rare cause of immunodeficiency characterized by the association of hypogammaglobulinemia and thymoma. This primary immune disorder may be complicated by severe infectious diarrhea secondary to disabled humoral and cellular immune response. This is the first description in the literature of an adult patient with an immunodeficiency syndrome who presented with protein-losing enteropathy secondary to giardiasis.
