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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v7i1.2616</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v7i1.2616</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Common Variable Immunodeficiency Presenting as Tuberculous Meningitis in a Young Asian Female- A Case Report</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Aftab</surname>
            <given-names>Uzma</given-names>
          </name>
          <email>uzmaaftab308@gmail.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Abid</surname>
            <given-names>Seemab</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ahsan</surname>
            <given-names>Mariya</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Saleem</surname>
            <given-names>Samar</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ambreen</surname>
            <given-names>Saima</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ashraf</surname>
            <given-names>Iqra</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Holy Family Hospital, Rawalpindi Pakistan</institution>
      </aff>
      <aff id="aff2">
        <institution>Rawalpindi Teaching Hospital, Rawalpindi Pakistan</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Uzma Aftab (uzmaaftab308@gmail.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2026-03-10">
        <day>10</day>
        <month>03</month>
        <year>2026</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2026</year>
      </pub-date>
      <volume>7</volume>
      <issue>1</issue>
      <fpage>77</fpage>
      <lpage>80</lpage>
      <history>
        <date date-type="received" iso-8601-date="2025-11-30">
          <day>30</day>
          <month>11</month>
          <year>2025</year>
        </date>
        <date date-type="rev-recd" iso-8601-date="2026-01-15">
          <day>15</day>
          <month>01</month>
          <year>2026</year>
        </date>
        <date date-type="accepted" iso-8601-date="2026-02-19">
          <day>19</day>
          <month>02</month>
          <year>2026</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2026 The Author(s)</copyright-statement>
        <copyright-year>2026</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v7i1.2616" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v7i1.2616.pdf" content-type="application/pdf"/>
      <abstract>
        <p>Common variable immunodeficiency disorders (CVID) represent primary immune deficiencies that manifest with complications involving infections and inflammation, primarily due to deficiencies in antibody production and occasionally affecting cellular immunity. A 20-year-old woman presented with symptoms of persistent mild fever, headache, sudden sensitivity to light, and a confused mental state, without any history of seizures. Since infancy, she had experienced recurrent airway and gastrointestinal infections. On examination, she was vitally stable with a temperature of 100.4°F, Glasgow Coma Score (GCS) of 9, positive signs of meningeal irritation, and bilateral coarse crackles on chest auscultation. Laboratory findings and cerebrospinal fluid (CSF) analysis were suggestive of tuberculous meningitis, and anti-tuberculous treatment was initiated. Further workup was performed considering the patient's susceptibility to repeated infections, and she was diagnosed with common variable immunodeficiency based on the Ameratunga criteria. Her condition markedly improved after the administration of parenteral immunoglobulin therapy. Delayed diagnosis of common variable immunodeficiency, often due to diverse patient presentations, can have grave outcomes as in this case; therefore, a history of recurrent infections should never be overlooked until a definite cause is established.</p>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>Common Variable Immuodeficiency</kwd>
        <kwd>CVID</kwd>
        <kwd>Tuberculosis</kwd>
        <kwd>Immunology</kwd>
        <kwd>Meningitis</kwd>
      </kwd-group>
    </article-meta>
  </front>
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  <back>
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</article>
