Common Variable Immunodeficiency Presenting as Juvenile Spondyloarthritis: Concerns about Increased Risk of Infections Associated with Immunosuppressive Agents

Common variable immunodeficiency (CVID) is a disorder characterized by defective B cell function leading to impaired immunoglobulin production. Although symptoms typically manifest between the second and fourth decades of life, they can emerge in childhood, with heterogeneous clinical manifestations such as recurrent infections, chronic lung disease, autoimmune disorders, gastrointestinal disease, or increased risk of malignancy. We report the case of a 17-year-old male with a personal background of rhonchopathy and recurrent otitis until the age of five, when he undergone adenoidectomy and bilateral tympanostomy with ventilation tubes. He remained asymptomatic until the age of 13, when he developed arthralgia affecting the spine, sternum, hips and knees. After clinical evaluation, he was diagnosed with CVID and juvenile spondyloarthritis (JSpA). He is under multidisciplinary care, including immunodeficiency, rheumatology, pneumology and medical genetics. His current treatment includes subcutaneous immunoglobulin and a selective COX-2 inhibitor. This case highlights the clinical presentation of CVID in pediatric patients, focusing on diagnostic approach and treatment strategies.