Longitudinally extensive transverse myelitis: a rare association with common variable immunodeficiency.

To cite: Jabbari E, Marshall CR, Longhurst H, et al. Pract Neurol 2015;15:49–52. INTRODUCTION Transverse myelitis requires careful investigation, as although many causes respond acutely to immunomodulation, the longer term management depends upon its precise cause. We describe a patient presenting acutely with a corticosteroidresponsive longitudinally extensive transverse myelitis and granulomatous lung lesions with a previous history of recurrent generalised lymphadenopathy, pyogenic infections and idiopathic thrombocytopenic purpura. We initially suspected an underlying primary autoimmune disorder. However, investigations showed granulomatous common variable immunodeficiency (gCVID) and following regular intravenous immunoglobulin, her symptoms did not recur. We discuss this relatively common immunodeficiency disease, frequently misdiagnosed as a systemic autoimmune disease (often sarcoidosis). We also discuss the range of neurological syndromes, including transverse myelitis, that may accompany common variable immunodeficiency (CVID).