Pernicious anaemia and granulomatous skin lesions in a case of common variable hypogammaglobulinaemia

A 45-year-old woman is reported with a history of recurrent bacterial infections since childhood; at the age of 37 years she developed recurrent ulcerated lesions around her mouth, in the groins and buttocks, which histologically contained small, non-caseating granulomas. A year later when being treated for empyema, she was found to have common variable hypogammaglobulinaemia. Three years after this she developed a megaloblastic anaemia of vitamin B₁₂-deficiency type.