[PAGID] Difficult diagnosis
Turvey, Stuart
sturvey at cw.bc.ca
Thu Jan 15 00:25:25 EST 2009
Could you provide a little more information?
Specifically, I was wondering:
-Any informative family history or consanguinity
-Any exam findings (rash, adenopathy, organomegaly)
-CBC data.....particularly the lymphocyte count at the time the lymphocyte phenotyping was done
Thanks,
Stuart
Stuart Turvey MB BS DPhil
Assistant Professor
Division of Infectious and Immunological Diseases
BC Children's Hospital and Child & Family Research Institute
Rm 371
950 West 28 Avenue
Vancouver BC V5Z 4H4
Ph: 604 875 2345 x5094
Fax: 604 875 2226
________________________________
From: pagid-bounces at list.clinimmsoc.org on behalf of Jane Peake
Sent: Wed 14/01/2009 8:13 PM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] Difficult diagnosis
I am uncertain what is wrong with this baby who certainly has a significant immune deficiency and would appreciate any ideas.
Kind regards
Dr Jane Peake
Female infant DOB 28/05/08
- Thrush -3/52- req topical and oral therapy
- RSV bronchiolitis - 22 weeks - requiring hospitalisation and oxygen - not ventilated
- Failure to thrive - Noted to have dropped across centiles from 10th at birth (length 25th) to well below 3rd centile
- Severe PCP pneumonia - 6/12age - ventilated and oxygen
Ix at 6/12 - IgG 0.5 (probably maternal) no IgA or IgM - no tetanus antibody titres - (fully immunised)
T and B cell subsets CD3 86%, CD4 51%, CD8 34%, CD19 6%, CD56/16 7%
PHA results
16/12/2008
02/01/2009
PHA conc.
Control
Patient
Control
Patient
0
582
306
59
179
0.63
1196
416
86
754
1.25
169462
481
75119
4115
2.5
306720
938
168981
9677
5
374675
5752
254529
23844
Chromosomes normal - no suggestion of abnormalities of Ch 1, 9, 16 following PHA stimulation (excludes ICF syndrome)
Dr Jane Peake
Paediatric Immunologist and Allergist
Royal Children's Hospital
Herston Rd
Herston QLD 4029
AUSTRALIA
Tel: (61 7) 33 65 53 33
Fax: (61 7) 33 65 54 55
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