Common Variable Immunodeficiency Presenting as Tuberculous Meningitis in a Young Asian Female- A Case Report
Abstract
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.
How to Cite This Article
Aftab U, Abid S, Ahsan M, Saleem S, Ambreen S, Ashraf I. Common Variable Immunodeficiency Presenting as Tuberculous Meningitis in a Young Asian Female- A Case Report. J Pak Soc Intern Med. 2026;7(1):77–80. doi:10.70302/jpsim.v7i1.2616
Conflict of Interest
All authors declare no competing interests.
Funding
No specific funding was received for this research.
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References
- Janssen LMA, van der Flier M, de Vries E. Lessons Learned From the Clinical Presentation of Common Variable Immunodeficiency Disorders: A Systematic Review and Meta-Analysis. Front Immunol. 2021;12:620709.
- Weifenbach N, Schneckenburger AAC, Lötters S. Global Distribution of Common Variable Immunodeficiency (CVID) in the Light of the UNDP Human Development Index (HDI): A Preliminary Perspective of a Rare Disease. J Immunol Res. 2020; https://doi.org/10.1155/2020/8416124 doi:10.1155/2020/8416124
- Cooper CJ, Said S, Quansah R, Khalillullah S, Alozie O. Pneumococcal meningitis in a young adult female with common variable immunodeficiency. Am J Case Rep. 2013; doi: 10.12659/AJCR.889617. doi:10.12659/AJCR.889617
- Ameratunga R, Woon ST, Gillis D, Koopmans W, Steele R. New diagnostic criteria for common variable immune deficiency (CVID), which may assist with decisions to treat with intravenous or subcutaneous immunoglobulin. Clin Exp Immunol. 2013;174(2):203–11.
- Tehrani S, Ziaie S, Kashefizadeh A, Fadaei M, Najafiarab H, Keyvanfar A. Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia? Front Med. 2022;9(2):1–5.
- de Martino M, Lodi L, Galli L, Chiappini E. Immune Response to Mycobacterium tuberculosis: A Narrative Review. Front Pediatr. 2019;7(1):464617.
- Chawla S, Barman P, Tyagi R, Jindal AK, Sharma S, Rawat A, et al. Autoimmune Cytopenias in Common Variable Immunodeficiency Are a Diagnostic and Therapeutic Conundrum: An Update. Front Immunol. 2022;13(1): 869466.
- Schiepatti A, Sanders DS, Baiardi P, Caio G, Ciacci C, Kaukinen K, et al. Nomenclature and diagnosis of seronegative coeliac disease and chronic non-coeliac enteropathies in adults: the Paris consensus. Gut. 2022;71(11):2218–25.
- Villanacci V, Vanoli A, Leoncini G, Arpa G, Salviato T, Bonetti LR, et al. Celiac disease: Histology-differential diagnosis-complications. A practical approach. Pathologica. 2020;112(3):186–96.
- Abolhassani H, Sagvand BT, Shokuhfar T, Mirminachi B, Rezaei N, Aghamohammadi A. A review on guidelines for management and treatment of common variable immunodeficiency. Expert Rev Clin Immunol. 2013;9(6):561–75.
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