[PAGID] CVID with absent IgG

[Saxon, Andy M.D.]

A colleague of mine recently saw a 58 yo man with a history of 10+ years of
recurrent pneumonia and one episode of bacterial sepsis. His QIG was IgA < 7
mg/dL (nl 80-400), IgG <8 mg/dl (nl 690-1660). IgE ,0.1 IU/mL. IgM not done
but "decreased" on IEP.  C3, C4, T and B cells % and # normal but CD4 28%
with absolute 294 (normal 355-1426.)  Albumin 3.1 with nl 3.3-4.7

I have seen a fair # of CVID in my time but I don't recall seeing one with
an IgG this low...  What is your experience.

Andy Saxon, UCLA