title: Posterior Cord Syndrome and Trace Elements Deficiency as an Uncommon Presentation of Common Variable Immunodeficiency.
abstract: Diarrhea is one of the most common symptoms in common variable immunodeficiency, but neurologic manifestations are rare. We presented a 50-year-old woman with recurrent diarrhea and severe weight loss that developed a posterior cord syndrome. Endoscopy found a duodenal villous blunting, intraepithelial lymphocytosis, and lack of plasma cells and magnetic resonance imaging of the spine was normal. Laboratory assays confirmed common variable immunodeficiency syndrome and showed low levels of trace elements (copper and zinc). Treatment was initiated with parenteral replacement of trace elements and intravenous human immunoglobulin and the patient improved clinically. In conclusion, physicians must be aware that gastrointestinal and neurologic disorders may be related to each other and remember to request trace elements laboratory assessment.
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Yuri
authors.identifier: 0000-0003-0494-5303
authors.initials: Y
authors.lastname: Silva Macedo
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Ananda
authors.initials: A
authors.lastname: Dos Santos Mota
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: Morais Monteiro
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Angela Cristina Gouvêa
authors.initials: AC
authors.lastname: Carvalho
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Barbara
authors.initials: B
authors.lastname: Fernandes Diniz
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Gemal Lanzieri
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carneiro Ramos
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Luis Otavio
authors.initials: LO
authors.lastname: Mocarzel
authors.affiliation: Department of Clinical Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-90 Niterói, RJ, Brazil.
authors.forename: Ronaldo Altenburg
authors.identifier: 0000-0002-0884-4190
authors.initials: RA
authors.lastname: Gismondi