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Recurrent myelitis in common variable immunodeficiency successfully managed with high-dose subcutaneous
Maria Giovanna Danieli1, Lucia Pettinari, Lucia Marinangeli
1Scienze Cliniche e Molecolari, Clinica Medica, Torrette di Ancona, Italy. m.g.danieli@univpm.it
BMJ Case Reports
|August 11, 2012
Summary
This case study shows that high-dose subcutaneous immunoglobulin effectively treats recurrent myelitis in a patient with common variable immunodeficiency (CVID). It helped maintain remission and reduce prednisone use over three years.
Area of Science:
- Neurology
- Immunology
Background:
- Acute myelitis is an inflammatory spinal cord disorder with diverse causes.
- Recurrent myelitis requires effective long-term management strategies.
Observation:
- A 71-year-old woman with recurrent myelitis, diagnosed with common variable immunodeficiency (CVID), experienced a new relapse.
- Neuromyelitis optica and other myelopathy causes were excluded.
Findings:
- Treatment with high-dose methylprednisolone and intravenous immunoglobulin was initiated.
- Subcutaneous immunoglobulin (SCIG) at 0.2 g/kg/week was used for remission maintenance.
- The patient showed good response with no relapses over a 3-year follow-up.
Implications:
- High-dose SCIG appears effective and safe for maintaining remission in CVID-associated recurrent myelitis.
- SCIG may allow for prednisone sparing in such cases.
- This approach offers a potential therapeutic option for managing complex myelitis cases.
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