Exceptional Association of a Common Variable Immunodeficiency and Ankylosing Spondylitis: A Case Report
Published: 2024-05-14
Page: 64-67
Issue: 2024 - Volume 7 [Issue 1]
H. Bellamine *
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
M. Moudatir
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
K. Echchilali
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
L. Barakat
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
M. Benzakour
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
H. Elkabli
Internal Medicine Department, CHU Ibn Rochd, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
We report a new observation of an unusual association of CVID with ankylosing spondylitis (AS). Osteoarticular involvement associated with CVID occurs in approximately 5 to 40% of cases, most commonly in the form of septic arthritis, or non-septic arthritis, which is part of the joint manifestations of autoimmune and rheumatic diseases associated with CVID. A 53-year-old patient with a history of recurrent bronchopulmonary infections complicated by bronchial dilatation since the age of 38, pelvic-axial syndrome and peripheral inflammatory arthralgia affecting the large and medium-sized joints and enthesitis (talalgia), who has presented since the age of 40 with a digestive disorder consisting of chronic liquid diarrhoea with 6 stools a day, developing in the context of a deterioration in her general condition, without any mention of medication. Regarding biotherapy, in particular anti-TNF alpha, this is the first-line biotherapy for APS. It has been shown to be effective in patients with CVID with joint involvement in the course of granulomatous disease, which would be beneficial for our patient.
Keywords: Ankylosing spondylitis, granulomatous diseases, immunoglobulins, autoimmune manifestations
How to Cite
Downloads
References
Vanaki N, Aslani S, Jamshidi A, Mahmoudi M. Role of innate immune system in the pathogenesis of ankylosing spondylitis. Biomedicine & Pharmacotherapy. 2018 Sep 1;105:130-43.
Díaz‐Peña R, López‐Vázquez A, López‐Larrea C. Old and new HLA associations with ankylosing spondylitis. Tissue antigens. 2012 Sep;80(3):205-13.
Revue du Rhumatisme. Bone and joint diseaseassociatedwithprimary immune deficienciese Christelle Sordet. 2005; 72:1270–1282. DOI:10.1016/j.rhum.2004.07.015.
Hansel TT, Haeny MR, Thompson RA. Primary hypogammaglobulinemia and arthritis. BMJ 1987;295:174–5.
Katherine A. al Osteoarticular infectious complications in patients with primary immune deficiency. DOI: 10.1097/BOR.0b013e3282fd6e70
Andres E, Limbach FX, Kurtz JE, Kurtz-Illig V, Schaeverbeke T, Kuntz JL, et al. Primary humoral immunodeficiency (late-onset common variable immunodeficiency) with antinuclear antibodies and selective immunoglobulin deficiency. Am J Med. 2001;111:489–91.
Fei Y. al The causal relationship between immune cells and ankylosing spondylitis: A bidirectional Mendelian randomization study. .Arthritis Res Ther. 2024 Jan 16;26(1):24. DOI: 10.1186/s13075-024-03266-0.
Maxime Samsono et al. Diagnostic strategy for patients with hypogammaglobulinemia in rheumatology. Joint Bone Spine. 2011;78:241–245.
Smith KJ et al. Common variable immunodeficiency treated with a recombinant human IgG, tumournecrosis factor-alpha receptor fusion protein. Br J Rheumatol. 2001;144:597–600.
Ben mulhearn et al.indication for igiv in rheumatic diseases; 2015, oxford.
Webster A D, et al. Polyarthritis in adults with hypogammaglobulinaemia and its rapid response to immunoglobulin treatment. Br Med J; 1976.