[PAGID] CF and hypogamma

[Brynn Wainstein]

Dear all,

I am hoping for some advice regarding a patient of mine. This is a 9
year old girl with DF508 homozygous cystic fibrosis who was found on
routine testing to have hypogamma with results as follows:

	28/07/08	08/10/08	18/12/08
IgG	2.89 		3.27		3.41	g/L (6 - 13)
IgM	0.4		0.39		0.46	g/L (0.4 - 1.6)
IgA	0.25		0.26		0.27	g/L (0.5 - 3)

Normal B cell numbers and T cell subsets. Otherwise clinically well with
no significant lung infections despite CF (she is colonised with
pseudomonas).

We are considering IVIg replacement despite her clinical wellness
because of concurrent CF and persistently low Ig levels. But some
reports in the literature suggest worse lung function in patients with
hypergamma but don't talk specifically about IVIg.

I would appreciate peoples thoughts and advice on whether this girl
should receive IVIg.

Kind Regards,

Brynn Wainstein.

Dr Brynn Wainstein
Paediatric Clinical Immunologist
Staff Specialist 
Sydney Children's Hospital
Tel: +61-2-9382-1515
Fax: +61-2-9382-1580




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