[PAGID] CF and hypogamma

Soheil Chegini schegini at hmc.psu.edu
Tue Jan 20 09:09:56 EST 2009


Does she have any GI issues? What is her nutritional status and her total protein and albumin levels?

Soheil Chegini, MD
Assistant Professor of Medicine & Pediatrics
Penn State Hershey Medical Center
500 University Dr. H041
Hershey, PA 17033
Tel. 717-531-6525
Fax 717-531-5785



>>> "Brynn Wainstein" <Brynn.Wainstein at SESIAHS.HEALTH.NSW.GOV.AU> 1/19/2009 10:20 PM >>>


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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