[PAGID] (no subject)

[HOWARD M LEDERMAN]

This case has the hallmarks of an early presentation of CVID with autoimmune disease, though
the IgA and IgE levels are a bit high.  Did she have evidence for hemolysis or reduced bone marrow production?  Do you have any evidence for GI infection?

Howard 
Howard M. Lederman, M.D., Ph.D.
Professor of Pediatrics and Medicine
Division of Pediatric Allergy and Immunology
Johns Hopkins Hospital - CMSC 1102
600 N. Wolfe Street
Baltimore, MD 21287-3923
Phone:  410-955-5883
Fax:    410-955-0229
e-mail: Hlederm1 at jhem.jhmi.edu


----- Original Message -----
From: "Sullivan, John  (Office of Research)" <John.Sullivan at umassmed.edu>
Date: Thursday, August 3, 2006 2:37 pm
Subject: [PAGID] (no subject)

> Colleagues, I would appreciate your thoughts about the following 
> patient; a 16 month old female who presented on July 16th, with a 
> severe anemia[hgb 6], FTT[ wt<3%, HT at 75%] neutropenia[ <5%] and 
> diarrhea; IgG 165, IgA 19, IgM 54, IgE 91; normal lymphocyte count 
> with normal T cells and normal CD4/CD8, normal B cell numbers; 
> patient has had all appropriate immunizations and has absent 
> antibodies to the following; tetanus/diphtheria/strep pneumo/hep 
> B/H Flu/ and Varicella; patient transfused and has stable 
> hematocrit and will receive IVIG tomorrow[ just received results 
> of immune workup]; thanks, John.
> 
> 
> John L Sullivan MD
> Professor of Pediatrics
> University of Massachusetts Medical School
> 55 Lake Avenue North
> Worcester MA 01655
> Phone 508-856-1572
> Fax 508-856-5004
> email john.sullivan at umassmed.edu
>