Section 21. Disorders of the Gastrointestinal System >
Part 1. Presenting Signs and Symptoms >
Chapter 391. Gastrointestinal Disorders Associated with ImmunodeficiencyRichard J. Noel
Topics Discussed: bacterial gastroenteritis; candida esophagitis; candidiasis, oral; cryptosporidial diarrhea; cryptosporidium; disseminated histoplasmosis; disseminated infection due to mycobacterium avium-intracellulare group; gastroenterology and hepatology; gastrointestinal candidiasis; gastrointestinal disease; gastrointestinal infections; giardia lamblia; giardiasis; immune system diseases; immunologic deficiency syndromes; immunology; opportunistic infections; viral gastroenteritis.
Excerpt:"Children with primary or acquired immunodeficiency are at increased
risk for infectious and inflammatory gastrointestinal disorders.1 The
risk and severity of infection depends on the type of immunodeficiency.
Individuals with deficiencies of antibody response are predisposed
to extracellular bacterial infections and intestinal pathogens.
Patients with deficiencies of T cells are predisposed to both intracellular
and extracellular infections. In addition, patients with primary
immunodeficiencies are more prone to develop autoimmune disorders
because of their decreased ability to distinguish self-organisms
from foreign organisms. Autoimmune diseases and celiac disease are
more common in the IgA-deficient patients.Gastrointestinal disorders in children with immunodeficiencies
can be associated with infectious (viruses, bacteria, mycobacteria,
fungi, or protozoa ) and noninfectious disorders (autoimmune and
alloimmune). Dysmotility, malabsorption, and malnutrition can be associated
with any of these disorders. In addition, medical treatments prescribed
for children with immunodeficiencies may have important gastrointestinal
complications.The pandemic of human immunodeficiency virus (HIV) infection and
acquired immunodeficiency syndrome (AIDS) has heightened our awareness
of opportunistic infections, most of which have been described either
in patients with primary immunodeficiencies or in immunosuppressed
patients with malignancies. These infections are listed in Table..."
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