[CIS PIDD] [cis-pidd] Positive NB Screen

[Routes, John]

Richard
you need to get the percentage of naive and memory T cells with the next draw--is the history and PE normal?
Jack



John M. Routes, MD
Chief, Section of Allergy and Clinical Immunology
Professor of Pediatrics, Medicine, Microbiology and Molecular Genetics
Department of Pediatrics
Children's Hospital of Wisconsin
Medical College of Wisconsin
9000 W. Wisconsin Ave.
Milwaukee, WI  53226-4874
Phone: Office 414-266-6840
Fax: 414-456-6487 (Clinical)
Fax: 414-456-6323 (Laboratory)
Email: jroutes at mcw.edu<mailto:jroutes at mcw.edu>





On Sep 6, 2013, at 4:08 PM, Richard Wasserman <drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>>
 wrote:

The data shown are all that I have to date. I am trying to be parsimonious in the phlebotomies and wanted some input before drawing more lab.
Richard


On Fri, Sep 6, 2013 at 2:40 PM, Harville, Terry O <HarvilleTerryO at uams.edu<mailto:HarvilleTerryO at uams.edu>> wrote:
Richard,

We see values like this in the Partial DiGeorge setting.

Were CD45RO and CD45RA evaluated?

Terry Harville MD PhD
-Medical Director, Special Immunology Laboratory
-Medical Director, Histocompatibility Laboratory
-Medical Director, Immunogenetics and Transplantation Laboratory
-Specialist in Pediatric Immunology and Rheumatology
Departments of Pathology and Laboratory Services and Pediatrics
University of Arkansas for Medical Sciences
4301 West Markham
Mail Slot #502
Little Rock, AR  72205-7199

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From: Richard Wasserman [mailto:drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>]
Sent: Friday, September 06, 2013 2:20 PM
To: CIS-PIDD
Subject: [cis-pidd] Positive NB Screen

I have been evaluating a normal term female with an abnormal SCID screen of "very low TRECs". The available data are below:

Day of life 38

Day of life 62

Abs.CD19+ Lymphs L 544 (/uL) 600-1900 01
Absolute CD 3 L 718 (/uL) 2300-7000 01
Absolute CD 4 Helper L 538 (/uL) 1700-5300 01
Abs. CD 8 Suppressor L 178 (/uL) 400-1700 01
Ab NK (CD56/16) 482 (/uL) 200-1400 01
WBC L 3.9 (x10E3/uL) 5.0-12.4 01

Abs.CD19+ Lymphs 1059 (/uL) 600-1900 01
Absolute CD 3 L 957 (/uL) 2300-7000 01
Absolute CD 4 Helper L 682 (/uL) 1700-5300 01
Abs. CD 8 Suppressor L 267 (/uL) 400-1700 01
Ab NK (CD56/16) 795 (/uL) 200-1400 01
WBC 5.1 (x10E3/uL) 5.0-12.4

Day of life 25 PHA = 47%, IgM = 10ml/dL

PHA day of life 47 = 111%

Adenosine deaminase 15.02




She has been well. As you can see, her PHA normalized and her counts are improving. I'd appreciate suggestions for further evaluation.

Richard Wasserman
Dallas
--
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
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Cell (214) 697-7211<tel:%28214%29%20697-7211>

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--
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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