Difficulty in Treatment of Inflammatory Arthritis in a Patient with Common Variable Immunodeficiency: A Case Report

Background: Common Variable Immunodeficiency (CVID) is the most common primary immunodeficiency in adults. Autoimmune complications occur in up to 30% of patients, including inflammatory arthritis that often resembles rheumatoid arthritis. Standard management typically involves immunoglobulin replacement , combined with disease - modifying antirheumatic drugs (DMARDs) and corticosteroids, which are effective in most cases.4,6 Case Presentation: We present a 55-year-old male with CVID who developed progressive inflammatory arthritis refractory to multiple regimens. His management was complicated by methotrexate - induced leukopenia, corticosteroid - induced osteoporosis, and limited specialty continuity. Despite therapy with immunoglobulin, DMARDs, and corticosteroids, his joint symptoms persisted and worsened. Discussion: This case underscores the challenges of treating autoimmune complications in immunodeficient patients. It highlights the importance of careful monitoring for drug toxicities, vigilance for secondary complications, and coordination across specialties. Conclusion: Inflammatory arthritis secondary to CVID is often responsive to immunoglobulin therapy and standard regimens but may prove challenging to treat when complications or contraindications limit treatment.