Peripheral Neuropathy Due to Common Variable Immunodeficiency: Case Report and Narrative Review

Area of Science:

• Neurology
• Immunology
• Genetics

Background:

• Common variable immunodeficiency (CVID) is a primary immune deficiency often associated with autoimmune phenomena and increased infection risk.
• Neurological complications of CVID are typically central nervous system (CNS) related, with peripheral nervous system (PNS) involvement being exceptionally rare.
• This case highlights a patient with CVID presenting with progressive lower extremity weakness and pain, unresponsive to initial treatments.

Purpose of the Study:

• To report a rare case of peripheral neuropathy in a patient with Common Variable Immunodeficiency (CVID).
• To review the literature on neurological manifestations of CVID.
• To emphasize the importance of considering PNS complications in CVID patients.

Main Methods:

• Case presentation of a 63-year-old woman with CVID and lower extremity symptoms.
• Electrophysiologic testing (nerve conduction studies and electromyography) to evaluate peripheral nerve function.
• Comprehensive literature review on CVID and associated neurological disorders.

Main Results:

• Electrophysiologic testing revealed a predominantly motor axonal neuropathy in the lower extremities.
• The patient's symptoms persisted despite extensive workup and treatment for other conditions.
• This represents the second documented case of peripheral neuropathy as a complication of CVID.

Conclusions:

• Peripheral neuropathy is a rare but significant neurological complication of CVID.
• Awareness of potential PNS involvement in CVID is critical for accurate diagnosis and management.
• Prompt identification and treatment of CVID-related neuropathy can mitigate risks of falls and improve physical function.