<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000300117</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Diarrea crónica por Lamblia intestinalis en un adulto]]></article-title>
<article-title xml:lang="en"><![CDATA[Chronic diarrhea by Lamblia intestinalis in an adult]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta-Acosta]]></surname>
<given-names><![CDATA[Josué]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villacís-Valencia]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Leiva-Suero]]></surname>
<given-names><![CDATA[Lizette]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escalona-Rabaza]]></surname>
<given-names><![CDATA[Milagros]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Orozco]]></surname>
<given-names><![CDATA[Lucas]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Técnica de Ambato Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Ambato ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital IESS Ambato  ]]></institution>
<addr-line><![CDATA[Ambato ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>3</numero>
<fpage>117</fpage>
<lpage>119</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000300117&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000300117&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000300117&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Se presenta un caso de inmunodeficiencia común variable en un paciente masculino, joven con larga historia (9 años) de procesos infecciosos gastrointestinales y respiratorios recurrentes; a pesar de los diferentes esquemas terapéuticos, con evidencia diagnóstica de niveles bajos de inmunoglobulinas de las clases IgG, IgM e IgA; se pretende comparar su evolución a partir de su historia clínica y los resultados de sus exámenes complementarios, con la bibliografía revisada. La inmunodeficiencia común variable explica un déficit primario de IgG (al menos 2 desviaciones estándar por debajo de los valores de referencia para su edad), al menos otra de las Ig (IgA o IgM) y una reducción o ausencia de producción de anticuerpos. Esta entidad se considera poco frecuente en términos de incidencia, aunque cursa muchas veces inadvertida por el predominio de sus efectos. Clínicamente, se manifiesta por la presencia de infecciones recurrentes con preponderancia de las respiratorias y gastrointestinales. Desde el punto de vista etiológico, su génesis es controversial, pero se describen niveles bajos de inmunoglobulinas y una reducción o ausencia de producción de anticuerpos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract We present a variable common immunodeficiency case in a young male patient with a long history (9 years) of recurrent gastrointestinal and respiratory infectious processes, despite the different therapeutic schemes, with diagnostic evidence of low levels of IgG, IgM And IgA; aiming to make a comparison of its evolution in function of its clinical history and the results of its complementary examinations, with the bibliography reviewed. Variable common immunodeficiency explains a primary IgG deficit (at least 2 standard deviations below the reference values for his age) and at least one other Ig (IgA or IgM) and a reduction or absence of antibody production. This entity is considered infrequent in terms of incidence, although it is often inadvertent due to the predominance of its effects. Clinically it is manifested by the presence of recurrent infections with preponderance of the respiratory and gastrointestinal. From an aetiological point of view, its genesis is controversial, but low levels of immunoglobulins and a reduction or absence of antibody production are all described.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[inmunodeficiencia común variable]]></kwd>
<kwd lng="es"><![CDATA[producción de anticuerpos]]></kwd>
<kwd lng="es"><![CDATA[infecciones recurrentes]]></kwd>
<kwd lng="en"><![CDATA[common variable immunodeficiency]]></kwd>
<kwd lng="en"><![CDATA[antibody production]]></kwd>
<kwd lng="en"><![CDATA[recurrent infections]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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