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A man with CTLA4 insufficiency had experienced chronic diarrhea since childhood and was later diagnosed with common variable immunodeficiency. Recurrent gastritis led to repeated endoscopies. At age 34, multiple gastric biopsies showed both poorly differentiated adenocarcinoma and well-differentiated tubular adenocarcinoma. No metastasis was found at that time.
He underwent total gastrectomy without perioperative chemotherapy. The operation treated the gastric cancer, but his underlying intestinal and immune problems remained severe. Prolonged diarrhea and enterocolitis continued for months after surgery despite immunosuppressive treatment.
Gastroscopy was used during follow-up to monitor for recurrent cancer. He never fully recovered from his broader medical problems. Twenty-five months after the gastrectomy, he developed Klebsiella pneumonia infection with sepsis and died.
He died from infection-related sepsis 25 months after the gastric surgery.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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