Silva Macedo Yuri, Dos Santos Mota Ananda, Morais Monteiro Priscila, Carvalho Angela Cristina Gouvêa, Fernandes Diniz Barbara, Gemal Lanzieri Pedro, Carneiro Ramos Ricardo, Mocarzel Luis Otavio, Gismondi Ronaldo Altenburg
Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
Case Rep Med. 2017;2017:9870305. doi: 10.1155/2017/9870305. Epub 2017 Mar 5.
Diarrhea is one of the most common symptoms in common variable immunodeficiency, but neurologic manifestations are rare. We presented a 50-year-old woman with recurrent diarrhea and severe weight loss that developed a posterior cord syndrome. Endoscopy found a duodenal villous blunting, intraepithelial lymphocytosis, and lack of plasma cells and magnetic resonance imaging of the spine was normal. Laboratory assays confirmed common variable immunodeficiency syndrome and showed low levels of trace elements (copper and zinc). Treatment was initiated with parenteral replacement of trace elements and intravenous human immunoglobulin and the patient improved clinically. In conclusion, physicians must be aware that gastrointestinal and neurologic disorders may be related to each other and remember to request trace elements laboratory assessment.
腹泻是常见可变免疫缺陷最常见的症状之一，但神经系统表现罕见。我们报告了一名50岁女性，反复腹泻且体重严重减轻，继而出现脊髓后索综合征。内镜检查发现十二指肠绒毛变钝、上皮内淋巴细胞增多且缺乏浆细胞，脊柱磁共振成像正常。实验室检测确诊为常见可变免疫缺陷综合征，并显示微量元素（铜和锌）水平较低。开始采用胃肠外补充微量元素和静脉注射人免疫球蛋白进行治疗，患者临床症状改善。总之，医生必须意识到胃肠道疾病和神经系统疾病可能相互关联，并记得要求进行微量元素实验室评估。
