Common variable immunodeficiency (CVID) is a disorder of the immune system. Patients are generally diagnosed in their adolescence and require regular immunoglobulin replacement. Due to their immune dysregulation, they are at increased risk of infections, autoimmune disease, and cancer. METHODS: To describe a case of mild COVID-19 in a patient with CVID and granulomatous interstitial lung disease on replacement immunoglobulin and infliximab. RESULTS: The patient is a 15 year old female with CVID, granulomatous interstitial lung disease, and hepatosplenomegaly with pancytopenia and portal hypertension. She receives weekly SCIG and monthly infliximab. In July, an uncle who visits frequently tested positive for COVID-19. Mother, father, and brother subsequently had mild nasal congestion and tested positive for COVID-19. Our patient developed symptoms of headache and nasal congestion, for which Azithromycin was prescribed and symptoms resolved. No fever, cough, shortness of breath, or loss of sense of smell or taste was reported. No hospitalization was required. Her most recent labs with lymphocyte subsets revealed normal CD4 and CD8 T cell levels, low CD19 B cell levels, and normal immunoglobulins. Follow up COVID-19 PCR testing 1 month later remains positive. CONCLUSIONS: There are concerns regarding persons with immunodeficiency being at higher risk of serious illness from COVID-19. However, our patient's clinical course suggests that certain types of immunodeficiency or immunomodulators may potentially limit the cytokine storm which causes some COVID-19 complications. Further studies are needed.

ObjectiveThe objective of this report was to describe the demographics, clinical characteristics and outcomes of patients with cancer presenting with arthritis following chemotherapy in Jeddah, Saudi Arabia.Patients and methodsThis is a retrospective case series report. We included any patient ≥18 years of age with an established diagnosis of cancer who had received standard therapeutic intervention and was subsequently diagnosed with arthritis after developing rheumatic symptoms either during or after treatment. Patients with clinical evidence of arthritis at the time of their cancer diagnosis were excluded.ResultsSeven cases from different centers were identified. Breast cancer was the most common type of cancer reported. The diagnosis of arthritis was established by a rheumatologist. Bilateral involvement of the metacarpophalangeal and proximal interphalangeal joints was the most common presentation. The knee, back, shoulder and wrist joints were less affected. Following treatment, one patient experienced complete resolution of symptoms, four patients symptomatically improved and one patient had no improvement.ConclusionArthritis can develop both during and after treatment of a malignancy. Solid tumors seem to be more commonly associated with this phenomenon. In this case series, the prognosis was poor as the majority of patients developed persistent arthritis.