[PAGID] patient who lacks long-term memory antibody responses

[Howard M Lederman]

I have a fascinating  12 yr old male patient with a history of recurrent infections (mostly upper and lower respiratory tract).  No individual infection has been overwhelmingly severe, but the sum of all infections leads to a significant number of school absences.He has low IgG and IgM levels with normal IgA levels.  He makes normal IgG antibody responses to a wide variety of vaccines, but does not seem to be able to maintain long-term immunity.  (See attached spreadsheet.  Sheet 1 tabulates the antibody and immunglobulin levels; sheet 2 lists the immunizations.)Is this a pattern that others have seen?    I am open to any ideas for further evaluation.  Would anyone offer this child gamma globulin? 
Howard
Howard M. Lederman, M.D., Ph.D. 
Professor of Pediatrics, Medicine and Pathology 
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 
Email: Hlederm1 at jhem.jhmi.edu 

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