[CIS PIDD] [cis-pidd] HYPERgammaglobulinemia

[Daniel Suez]

I will still ask for protein electrophoresis.
Dan


Allergy, Asthma & Immunology Clinic PA

Daniel Suez, MD
Board Certified in Allergy & Immunology and
Diagnostic Laboratory Immunology
Clinical Associate Professor
UT Southwestern Medical School at Dallas
Allergy & Immunology Division
1115 Kinwest Pkwy, Suite 100
Irving TX 75063
T: 972-401-0545  C: 214-708-0727

From:  "Boyce, Thomas G., M.D." <Boyce.Thomas at mayo.edu>
Reply-To:  CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Date:  Tuesday, July 30, 2013 2:31 PM
To:  CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Subject:  [cis-pidd] HYPERgammaglobulinemia

I have been seeing a 5 year old boy for recurrent infections, mostly
respiratory.  He has asthma, so some of his recurrent pneumonias may be
asthma, but some outside CXRs show consolidation suggestive of true
pneumonia.  Initial workup one year ago was normal, except for an IgG of
1800.  I saw him back six months later and repeated it and it was 2600.  I
brought him back six months later and today it is 3000 (normal 386-1470).
He has normal T and B cell subsets, negative HIV antibody, normal IgA, IgM,
IgD, and IgE.  Normal UA.  Normal sweat chloride. Normal ACE.
 
I ran it by the peds hematologist to make sure there was not some monoclonal
gammapathy to look for and she dismissed the idea in a 5 year old.  I have
not seen this degree of elevated IgG before.  Any thoughts?
 
 
Thomas G. Boyce, MD, MPH
Pediatric Infectious Diseases and Immunology
Mayo Clinic
email: boyce.thomas at mayo.edu
phone: 507-255-8464
fax: 507-255-7767
 
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