[PAGID] pulmonary nodules and hyper-IgM

[Brooks, Edward G]

Have you looked for atypical bacteria? Mycoplasma, legionella or chylamidophila

Edward G. Brooks, MD
UTHSCSA, Dept. of Pediatrics
Division of Immunology and Infectious Disease, Rm. 528L
7703 Floyd Curl Drive
San Antonio, Texas 78229-3900
brookse at uthscsa.edu
tel: 210-567-5250
fax: 210-567-6305


-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of christian.wysocki at yale.edu
Sent: Wednesday, August 11, 2010 7:25 PM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] pulmonary nodules and hyper-IgM

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