[CIS PIDD] [cis-pidd] HYPERgammaglobulinemia

[dmvascon at usp.br]

Besides previous suggestions I would like to propose also an autoimmune hepatitis, that usually presents with very high polyclonal IgG levels. 
Nevertheless as Daniel suggested I would look for a possible B cell clonality. 
Certainly non-immunological diseases as CF and others as suggested previously are important too. 

Best, 

Dewton 

Dewton de Moraes Vasconcelos 
University of São Paulo School of Medicine 
----- Mensagem original -----


> De: "Thomas G. Boyce, M.D." <Boyce.Thomas at mayo.edu>

> Para: "CIS-PIDD" <cis-pidd at lists.clinimmsoc.org>

> Enviadas: Terça-feira, 30 de Julho de 2013 18:34:27

> Assunto: RE:[cis-pidd] HYPERgammaglobulinemia



> thanks, forgot to mention normal neutrophil oxidative burst.



> From: bounce-43648692-183824398 at lists.clinimmsoc.org

> [mailto:bounce-43648692-183824398 at lists.clinimmsoc.org] On Behalf Of

> Church, Joseph

> Sent: Tuesday, July 30, 2013 3:37 PM

> To: CIS-PIDD

> Subject: RE:[cis-pidd] HYPERgammaglobulinemia



> Consider:

> HIV

> CGD

> Autoimmune disease including inflammatory bowel disease.



> From: Boyce, Thomas G., M.D. [mailto:Boyce.Thomas at mayo.edu]

> Sent: Tuesday, July 30, 2013 12:31 PM

> To: CIS-PIDD

> 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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