[PAGID] pulmonary nodules and hyper-IgM

[christian.wysocki at yale.edu]

We follow an 11 yr old boy with X-linked HIGM, who has had many severe sequelae
including PCP, viral encephalitis, chronic cryptosporidial infection leading to
PSC and now cirrhosis.  He now has a chronic, indolent nodular process in both
lungs, noted on CTs in 10/2009 and now slightly worse on CT 7/2010.  He was
bronched in 7/2010, but BAL was negative for any bacterial, fungal,
mycobaterial organisms; transbronchial biopsy showed only "mild non-specific
chronic inflammation and fibrosis" and FNA of enlarged mediastinal nodes was
unremarkable.  No evidence of a granulomatous process either.

Wondering if anyone has seen pulmonary nodules in hyper-IgM and if there is
anything we might be missing.

Thanks for your time,

Chris Wysocki
Yale A/I fellow