Neurológia pre prax 4/2026

When immunology turns into neurology: the case of a patient with common variable immunodeficiency

In the first part of this article, we present a case of a patient with common variable immunodeficiency (CVID), who was admitted to the neurological department of Teplice district hospital due to rapid progression of gait disturbance. Neurological evaluation revealed apparent truncal ataxia and ataxia of the lower limbs, as well as a mild ataxia of the right upper extremity. MRI showed signs of cervical myelopathy, further investigation uncovered a gastric adenocarcinoma as the cause of a paraneoplastic syndrome. The patient’s condition improved significantly after gastrectomy and treatment with prednisone. In the second part of the article, we provide a concise review of CVID as a state of both hypogammaglobulinemia, and immune dysregulation. Statistic on the most common tumours is presented, gastric neoplasias among them. Information on most common neurological complaints, their frequency compared to the general and neurological patient populations, and influence on quality of life is mentioned. Neuroinfections as the most typical neurological complications and their most common causative agents are listed. Autoimmune conditions, their typical clinical forms, and potential therapeutic approach are described. Less frequent complications (granulomatosis, their similarity with sarcoidosis and treatment, and neuroendocrine disorders) are also mentioned. In concluding part, we share a few take-home messages.

Keywords: common variable immunodeficiency, CVID, paraneoplastic syndrome, cervical myelitis, gastric carcinoma