Vitamin E deficiency induced neurological disease in common variable immunodeficiency: two cases and a review of the literature of vitamin E deficiency.
Vitamin E deficiency causes a neurological disorder characterised by sensory loss, ataxia and retinitis pigmentosa due to free radical mediated neuronal damage. Symptomatic vitamin E deficiency has been reported in genetic defects of the vitamin E transport protein and in malabsorption complicating cholestasis, abetalipoproteinaemia, celiac disease, cystic fibrosis and small bowel resection. There are no reports to date of vitamin E deficiency in patients with primary immunodeficiencies. We describe two CVID patients with the associated enteropathy who developed neurological disease because of vitamin E deficiency, suggesting a possible predisposition to developing this complication. We recommend that all CVID patients with evidence of an enteropathy be screened for vitamin E deficiency, as early detection and consequent treatment may prevent, halt or reverse the neurological sequelae.
Aslam
A
A
Department of Immunology, Oxford Radcliffe Hospitals, John Radcliffe Campus, Headington, Oxford OX3 9DU, UK.
Misbah
S A
SA
Talbot
K
K
Chapel
H
H
D000328:Adult; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology; D014811:Vitamin E Deficiency / Q000150:complications* / Q000276:immunology / Q000473:pathology / Q000628:therapy