Common Variable Immunodeficiency and Hodgkin Lymphoma in a 50-Year-Old Male

TL;DR

A 50-year-old man with CVID and Hodgkin lymphoma highlights the need for better recognition of immunodeficiency in cancer patients.

Contribution

This case emphasizes the underdiagnosed link between CVID and Hodgkin lymphoma.

Findings

The patient had low IgG and IgM levels, consistent with CVID.

Nodular lymphocyte-predominant Hodgkin lymphoma was confirmed via immunohistology.

CVID was associated with lymphoma and gastrointestinal symptoms.

Abstract

Common variable immunodeficiency (CVID) is a primary immunodeficiency with the involvement of B cells, T cells, and antigen-presenting cells. Patients with CVID are more susceptible to malignancies and bacterial infections in the gastrointestinal and respiratory tracts. We discuss a case of a 50-year-old male who presented to the emergency department with a history of intermittent abdominal pain, diarrhea, night sweats, fever, nausea, and weight loss of 40 pounds over six months. A CT of the abdomen revealed splenomegaly with several infiltrated solid nodules as well as enlarged mediastinal, hilar, periesophageal, cervical, and left supraclavicular lymph nodes, findings suggestive of lymphoma. The diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma was confirmed by immunohistology, which revealed that CD20 and CD3 were both positive in small lymphocytes. Immunoglobulin (Ig) levels were low for IgG and IgM, findings highly suggestive of CVID. We want to shed light on the importance of performing the clinical workup for CVID when Hodgkin lymphoma and recurrent infections are present, as the immunodeficiency remains underdiagnosed and underreported.

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