[CIS PIDD] [cis-pidd] HYPERgammaglobulinemia

[Boyce, Thomas G., M.D.]

Thanks. That is helpful. He does have low level EBV viremia but no symptoms and not sure what to make of that. Thanks to everyone for all the good suggestions. I will let you know what I find.

Tom

On Aug 4, 2013, at 11:44 AM, "Markus G Seidel, Priv.-Doz.Dr." <markus.seidel at medunigraz.at<mailto:markus.seidel at medunigraz.at>> wrote:

consider ataxia teleang. (even before other features, check AFP) or nijmegen breakage syndrome (head circumference?, T cell proliferation),
I would suggest to do immune electrophoreses even in the young child, monitor ESR, exclude chronic (viral?) infections, lymphoma.
kindly yours, Markus Seidel,
Graz, Austria

Am 30.07.2013 um 21:31 schrieb Boyce, Thomas G., M.D.:

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<mailto:boyce.thomas at mayo.edu>
phone: 507-255-8464
fax: 507-255-7767


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