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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Recurrent myelitis in common variable immunodeficiency successfully managed with high-dose subcutaneous immunoglobulin
  1. Maria Giovanna Danieli1,
  2. Lucia Pettinari2,
  3. Lucia Marinangeli3,
  4. Francesco Logullo4
  1. 1Scienze Cliniche e Molecolari, Clinica Medica, Torrette di Ancona, Italy
  2. 2Ospedale Carlo Urbani, Medical and Surgery Emergency Unit, Jesi, Italy
  3. 3Scienze Cliniche e Molecolari, Immunologia, Torrette di Ancona, Italy
  4. 4Scienze Neurologiche, Clinica Neurologica, Torrette di Ancona, Italy
  1. Correspondence to Professor Maria Giovanna Danieli, m.g.danieli{at}univpm.it; mgdanieli{at}mail.com

Acute myelitis is an aetiologically heterogeneous inflammatory disorder of the spinal cord. We report on a 71-year-old woman with a recurrent cervical and thoracic myelitis who presented with a new relapse of the disease. Neuromyelitis optica was ruled out such as other possible causes of acute and/or recurrent myelopathy. Serum immunoglobulin levels and specific antibody responses were consistent with the diagnosis of common variable immunodeficiency (CVID). She was treated with high-dose methylprednisolone and intravenous immunoglobulin. As a remission-maintaining drug, we decided to treat her with subcutaneous immunoglobulin (CSL Behring) at 0.2 g/kg/week at doses higher than usually employed in replacement therapy in CVID. At 3-year follow-up, the response to treatment was good. No relapses occurred. Our case suggests the effectiveness and safety of subcutaneous immunoglobulin in maintaining remission and in sparing prednisone in a woman with recurrent myelitis associated with CVID.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.