Safety of Hormonal Contraceptives in Patients With Common Variable Immunodeficiency (CVID) Receiving Immunoglobulin Replacement: Evaluating the Risk of Thromboembolism

This case report discusses the use of hormonal contraceptives in patients with common variable immunodeficiency (CVID) who are on immunoglobulin replacement therapy (IgRT) and the risks of thromboembolism.We present a case of a 32-year-old female with CVID on weekly subcutaneous immunoglobulin (SCIG) who required consultation regarding thromboembolism risk prior to initiation of hormonal contraception for the treatment of dysmenorrhea and endometriosis.In this case, we explore the thromboembolic risks of IgRT and hormonal contraceptives, as well as considerations for an immunodeficient patient on replacementdose immunoglobulin supplementation with gynecological conditions.While there are no clear guidelines on this issue, treatment considerations involve selection of the appropriate hormonal contraceptive, the appropriate route of contraceptive delivery, and recognition that SCIG replacement has fewer systemic adverse events than intravenous immunoglobulin (IVIG) replacement.