[CIS-PAGID] FW: Immunodeficiency Question

[Church, Joseph]

Re 2yo ex premie with chronic diarrhea and recurrent gi infections:

 

*        Did small bowel biopsies show plasma cells?

*        Were the biopsies consistent with an auto immune enteropathy?

*        Consider obtaining secretory IgA

*        Was a total IgE done?

*        Did the symptoms respond to an elemental formula?

 

Joe Church

Childrens Hospital Los Angeles

 

 

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Routes, John
Sent: Wednesday, November 03, 2010 3:01 PM
To: pagid at list.clinimmsoc.org
Subject: [CIS-PAGID] FW: Immunodeficiency Question

 

 

All---see email from Dr. Nozad---if you have suggestions, please respond

thanks

Jack Routes

 

 

 

------ Forwarded Message

From: Cyrus Nozad <cnozad at yahoo.com>

Date: Wed, 3 Nov 2010 10:37:34 -0500

To: John Routes <jroutes at mcw.edu>

Subject: Immunodeficiency Question

 

Dear Dr. Routes,

My name is Cyrus Nozad and I recently finished up my fellowship at UT

Memphis and am currently a full time faculty member at Columbia in NYC.
I

have a patient that I am not sure what do with, the case is below. I
would

appreciate any input.

 

The patient is a 2 yo ex-Preemie F w/ FTT and chronic diarrhea since
August

2009, at 1 year of age(initially 8-9 watery stools per day). She started

developing chronic diarrhea at 1 year of age after receiving Amoxicllin.
She

has had C-Diff x4, 1 episode of aeromonas hydrophilia in the stool and

recently Salmonella in the stool. She has had an extensive workup by GI

upper and lower endoscopy. Has never had ear, sinus or lung infections.

There is no family history of immunodeficiency, miscarriage or early
death.

Serum Igs were normal, T+B cell enumeration normal, mitogens normal
(except

absent response to candida), oxidative burst normal, tetanus titer 2.0

(protective), sweat test negative x 2, C3/ C4 normal, and HIV negative.

 

Thank you

 

Cyrus

 

 

      

 

------ End of Forwarded Message

 



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