[PAGID] CVID with absent IgG

[Ashish Kumar]

Sorry group, I thought I was sending this email to Scott Baker, but it
went to all. But, I would appreciate any input from others who have the
time.
Thanks!

Ashish Kumar, M. D., Ph. D.
Assistant Professor
Pediatric Hematology/Oncology/Blood and Marrow Transplantation
University of Minnesota

-----Original Message-----
From: pagid-bounces at clinimmsoc.org [mailto:pagid-bounces at clinimmsoc.org]
On Behalf Of Ashish Kumar
Sent: Tuesday, December 06, 2005 9:22 AM
To: pagid at clinimmsoc.org
Subject: RE: [PAGID] CVID with absent IgG

Scott,

Joe saw a 7 yr old boy who has had recurrent otitis since the age of 5
weeks, 2 bouts of pneumonia, cryptosporidium diarrhea and many other
things. He did a basic work up - IgG, A, M and E were normal, Diphtheria
and tetanus titres were reactive; absolute CD19, CD16/56 and CD4 were
normal, but absolute CD8 count was slightly lower than normal. 

I think he has something, don't know what though. I was proposing to
perform T-cell and NK-cell functional studies. I haven't seen him, so
don't know if he has crooked teeth. Your thoughts?

Thanks!
Ashish

Ashish Kumar, M. D., Ph. D.
Assistant Professor
Pediatric Hematology/Oncology/Blood and Marrow Transplantation
University of Minnesota

-----Original Message-----
From: pagid-bounces at clinimmsoc.org [mailto:pagid-bounces at clinimmsoc.org]
On Behalf Of K. Scott Baker
Sent: Tuesday, December 06, 2005 8:44 AM
To: pagid at clinimmsoc.org
Subject: Re: [PAGID] CVID with absent IgG

We recently saw a 16 yr old female admitted to the general peds service
with
pneumonia several months ago with the same immunoglobulin picture (IGG
around 40).  No significant prior history outside of the few months
prior to
admission. Rest of workup has been uninformative.
-- 
K. Scott Baker, MD, MS
Associate Professor of Pediatrics
University of Minnesota


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> From: "Saxon, Andy M.D." <ASaxon at mednet.ucla.edu>
> Reply-To: <pagid at clinimmsoc.org>
> Date: Mon, 5 Dec 2005 08:35:22 -0800
> To: "'pagid at clinimmsoc.org'" <pagid at clinimmsoc.org>
> Cc: "Stacy Lee (E-mail)" <slee52 at ucla.edu>
> Subject: RE: [PAGID] CVID with absent IgG
> 
> Thanks. Nice to know as we didn't know if this represented anything
out of
> the regular spectrum. I guess not.
> 
> Andy
> 
> -----Original Message-----
> From: Charlotte Cunningham-Rundles
> [mailto:charlotte.cunningham-rundles at mssm.edu]
> Sent: Friday, December 02, 2005 2:32 PM
> To: pagid at clinimmsoc.org
> Subject: Re: [PAGID] CVID with absent IgG
> 
> 
> we have a group of these ---- it is always interesting how little Ig
> you can find in these adults
> 
>> 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
> 
> 
> -- 
> 
> 
> Charlotte Cunningham-Rundles MD PhD
> Professor of Medicine, Pediatrics  and Immunobiology
> Mount Sinai School of Medicine
> 1425 Madison Ave, New York 10029
> phone 212 659 9268
> fax  212 987 5593
> Email:  charlotte.cunningham-rundles at mssm.edu
>