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Rheumatoid arthritis in a patient with common variable immunodeficiency: difficulty in diagnosis and therapy
J Swierkot1, A Lewandowicz-Uszynska, A Chlebicki
1Department of Rheumatology, Medical University Wrocłw, ul Wiśniowa 36A 55-012, 53-137 Zerniki Wrocłwskie, Wrocłw, Poland. jurekswierkot0@poczta.onet.pl
Clinical Rheumatology
|June 9, 2005
Summary
Common variable immunodeficiency (CVID) can present as rheumatoid arthritis in adults. Early diagnosis and multidisciplinary care are crucial for managing CVID-associated arthritis and infections.
Area of Science:
- Immunology
- Rheumatology
- Internal Medicine
Background:
- Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by recurrent infections and autoimmune diseases.
- Adult-onset CVID often presents with non-specific symptoms, complicating diagnosis.
Observation:
- A 38-year-old woman with recurrent infections and pernicious anemia presented with polyarthralgia and fever.
- Immunological evaluation revealed hypogammaglobulinemia and altered lymphocyte subsets.
- HLA-DRB1*01 was identified in the patient.
Findings:
- Intravenous immune globulin therapy led to arthritis remission, but subsequent imaging revealed rheumatoid arthritis-like joint erosions.
- The patient's presentation of arthritis, recurrent infections, and autoimmune disease indicated CVID.
Implications:
- Arthritis can be an initial manifestation of primary immunodeficiency in adults.
- Prompt diagnosis and collaborative specialist management are essential for CVID patients with complex presentations.
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