[CIS PIDD] [cis-pidd] HYPERgammaglobulinemia

[Richard Wasserman]

What about chronic infection with other herpes group viruses?
Richard Wasserman


On Sun, Aug 4, 2013 at 12:18 PM, Boyce, Thomas G., M.D. <
Boyce.Thomas at mayo.edu> wrote:


>  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> 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

> phone: 507-255-8464

> fax: 507-255-7767****

>  ** **

>

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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
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Fax (972) 566-8837
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