Acta Neurol Belg (2017) 117:761–763 DOI 10.1007/s13760-016-0722-2 LETTER TO THE EDITOR Transient IgG deﬁciency with lesions in brain and spinal cord: a mimicker of common variable immunodeﬁciency syndrome 1 2 3 • • Konark Malhotra Ramnath Santosh Ramanathan Thomas F. Scott Received: 5 September 2016 / Accepted: 5 November 2016 / Published online: 15 November 2016 Belgian Neurological Society 2016 Introduction travel history, skin rash or any tick bites prior to admission. Her neurological exam was negative for bulbar signs, sensory Patients with immune deﬁciency states often present with abnormalities, sphincter dysfunction or meningismus. MRI- clinical perplexing disease processes, especially involving brain and spine with contrast demonstrated an extensive lesions of the central nervous system (CNS). Common vari- inﬁltrative process involving basal ganglia, hypothalamus and able immune deﬁciency (CVID) is a rare primary immune conus medullaris, with enhancing lesions in the upper cervical deﬁciency disorder that is usually associated with multi-organ cord and conus medullaris (Fig. 1a–c). Our clinical and radi- reversible inﬂammatory granulomatous lesions, though rarely ological differential diagnosis primarily included lymphoma, present with CNS manifestations. CNS involvement in CVID neurosarcoidosis, and infectious granulomatous diseases. can mimic neuroinﬂammatory disorders such as neurosar- Neuroimaging characteristics of the lesions were
Acta Neurologica Belgica – Springer Journals
Published: Nov 15, 2016
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