Arjun Adapa and Sudhir Sekhsaria
Common-variable immunodeficiency (CVID) is a heterogeneous disorder characterized by recurrent bacterial infections, hypogammaglobulinemia, and impaired antibody responses. Patients with CVID can remain undiagnosed for many years but carry an increased risk for developing B cell derived non-Hodgkin’s lymphomas, such as Burkitt’s lymphoma. Screening for CVID in patients diagnosed with Burkitt’s lymphoma is necessary before prescribing treatments, because certain regimens may significantly increase the risk for flare-up of CVID that could result in prolonged immunodeficiency. We present a patient who was diagnosed with Burkitt’s lymphoma and sustained prolonged severe immunodeficiency after receiving a complete course of rituximab and chemotherapy treatment. This case report illustrates the need for an immunological work-up in lymphoma patients before initiation of treatment because of the increased incidence of lymphoma in patients with immunodeficiencies. Patients with lymphoma should also be monitored longitudinally for immunodeficiencies after treatment with rituximab with or without chemotherapy.
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