[PAGID] Difficult diagnosis
Notarangelo, Luigi
Luigi.Notarangelo at childrens.harvard.edu
Thu Jan 15 11:15:58 EST 2009
Any data on naïve vs, memory T cells? T cell repertoire? Serum IgE?
Luigi D. Notarangelo, M.D.
Jeffrey Modell Chair of Pediatric Immunology Research in Boston
Director, Research and Molecular Diagnosis Program on Primary Immunodeficiencies
Division of Immunology, Children's Hospital
Professor of Pediatrics and Pathology, Harvard Medical School
Karp Building, 9th floor, Rm 09210
1 Blackfan Circle
Boston, MA 02115
USA
(tel) (617)-919-2276
(fax) (617)-730-0709
Secretary: Luisa Raleza
email: luisa.raleza at childrens.harvard.edu
On 1/14/09 11:13 PM, "Jane Peake" <j.peake at uq.edu.au> wrote:
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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