CASE REPORT: LEPROSY ASSOCIATED TO COMMON VARIABLE IMMUNODEFICIENCY

Abstract

Introduction: Common variable immunodeficiency (CVID) is characterized by recurrent infections and, less often, opportunistic infections. Objective: To report a patient with CVID and leprosy. Case: White male, 25 years, with CVID diagnostic established 2 ½ years before, under IGIV monthly replacement. Two years after the diagnosis of CVID, he reported recent appearance of hypopigmented anesthetic spots in the upper limbs and trunk. Skin biopsy: lymphocytic inflammatory infiltrate with sketches of perivascular and perianexial granulomas attacking nerve fibers in the middle and deep dermis. The bacterial index, the tuberculin skin test and research for HIV were negative. The diagnosis of borderline tuberculoid leprosy was established. The number of TCD4+ cells was lower before (572 cells/mm 3) than after (665 cells/mm 3) skin lesions detection. We found no previous reports in the literature of leprosy associated to CVID. Conclusion: We speculate if in this CVID patient the skin lesions corresponded to inflammatory immune reconstitution syndrome (IRIS) associated to leprosy andif IGIVreplacement could modified the outcome of a previous infection by M. leprae.