[CIS PIDD] [cis-pidd] Protein losing enteropathy

[Santhosh Kumar/FS/VCU]

Hello,
I would appreciate any input regarding this case. I tried to search the 
literature but  there is not much on this topic. 
I am seeing a 4 y/o child in consultation with GI who has protein losing 
enteropathy which they are trying to figure out the cause. He has had an 
endoscopy and colonoscopy which are normal. His immunoglobulins are 
trending down and most recent one is IgG 164, IgM 24, IgA 73. His 
lymphocyte enumeration is normal. His vaccine titers were low to start 
with but have responded well to vaccination challenge. He has no hx of 
recurrent infections. I was wondering if there is any reason to treat him 
with IVIG. The IgG level makes me little nervous but given his vaccine 
titers are protective i am willing to observe. 

Thank you,

Santhosh Kumar, MD
Assistant Professor,
Training Program Director
Allergy & Immunology
Medical College of Virginia
Ph:804-628-1605
Fax-804-828-1751
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