A 27 year-old-man was admitted to our hospital with pain in the back. Bone mineral density evaluation revealed severe osteoporosis at L1L4 vertebrae, as well as on femur, too. Secondary osteoporosis reasons like thyrotoxicosis, glucocorticoid therapy, hypercortisolemia, hypercalciuria, hyperparathyroidism were excluded. Laboratory examination of the patient revealed to a hypoglobulinemia. Further evaluation of the immunoglobulin levels were in concordance with panhypoglobulinemia. The patients vit D level was also low. The patient had been diagnosed as to having a Common variable Immune Deficieny. Common variable immunodefiency (CVID) is characterized with B-cell and T-cell dysfunction and hypogammaglobulinemia. Recurrent bacterial infections, diminished Ig levels and impaired antibody production are frequent observed problems of CVID. The most common infections are recurrent otitis media, chronic sinusitis and recurrent pneumonia sometimes leading to bronchiectasia. Almost half of the patients experience problems in the gastrointestinal tract and these may be associated with malabsorption due to chronic diarrhoea. Malabsorption may be observed among CVID patients. Our patients low vit D level was attributed to malabsorption. Osteoporosis at a young age especially in young men should be always extensively evaluated and accompanying hypoglobulinemia maybe a clue for CVID.
25 - 29 Apr 2009
European Society of Endocrinology