[CIS PIDD] [cis-pidd] Low TRECs, nromal mitogens, progressive lymphopenia

Wed Jan 7 08:15:46 EST 2015

Hi Richard,

I agree with the previous posts that a hypomorphic SCID or related mutation would be a consideration, though completely normal mitogens would argue against that to a degree.   Is uric acid normal?

I think our approach would be to go ahead with sequencing, and check antibody and antigen responses in the next few months.

Best regards,
Mike

-------------------------

Michael D. Keller MD

Assistant Professor, Division of Allergy / Immunology

Center for Cancer and Immunology Research

Children's National Health System

111 Michigan Ave NW, Room 1W-314B

Washington, DC 20010

Clinic: 202.476.3016

Office: 202.476.5843

Fax: 202.476.2280

www.childrensnational.org

________________________________
From: Daniel Conway [dhconway at hotmail.com]
Sent: Tuesday, January 06, 2015 10:15 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] Low TRECs, nromal mitogens, progressive lymphopenia

I am interested in another downstream function of genes involved in recombination- like specific antibody formation.

Sincerely,
Daniel H. Conway, MD
Assistant Professor of Pediatrics
St. Christopher's Hospital for Children
Drexel University College of Medicine

On Jan 6, 2015, at 9:37 PM, Richard Wasserman <drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>> wrote:

IgM at three weeks of age was 46mg/dL

On Tue, Jan 6, 2015 at 8:21 PM, Cooper, Megan <Cooper_M at kids.wustl.edu<mailto:Cooper_M at kids.wustl.edu>> wrote:
Hi Richard - it looks as if all the populations are dropping, I might consider ADA (somewhat delayed onset).

Megan

Megan A. Cooper, MD, PhD
Assistant Professor, Department of Pediatrics
Division of Rheumatology
Washington University School of Medicine
Cooper_m at kids.wustl.edu<mailto:Cooper_m at kids.wustl.edu>
Lab website: http://research.peds.wustl.edu/Default.aspx?alias=research.peds.wustl.edu/Labs/Cooper_M<https://urldefense.proofpoint.com/v2/url?u=http-3A__research.peds.wustl.edu_Default.aspx-3Falias-3Dresearch.peds.wustl.edu_Labs_Cooper-5FM&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=WuAW1f8At-utJgbqJWLIYYIUUF-_wFfDUY_0W-FkBQU&e=>

On Jan 6, 2015, at 7:47 PM, Richard Wasserman <drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>> wrote:

Please give me your thoughts on the best next steps for this six month old male who is thriving and has never been infected.

July 3, 2014 - Date of Birth

July 4, 2014, July 11, 2014 - Very Low TRECs

July 25, 2014

Absolute Lymphocytes L 3428 (cells/uL) 3400-7600

Absolute Cd3+ Cells L 1845 (cells/uL) 2500-5500

Absolute Cd4+ Cells L 1435 (cells/uL) 1600-4000

Absolute Cd8+ Cells L 389 (cells/uL) 680-1700

Absolute Nk Cells (cd16+cd56+cells) 735 (cells/uL) 170-1100

Absolute Cd19+ Cells L 828 (cells/uL) 300-2000

Absolute Cd3+Cd4+Cd45RA+Cd62L+ 1260 (cells/uL) 1200-3600

Absolute Cd3+Cd4+Cd45RO+ 232 (cells/uL) 60-900

Absolute Cd3+Cd8+Cd45RA+Cd62L+ 363 (cells/uL) 3800-1300

Absolute Cd3+Cd4+Cd45RO+ 18 (cells/uL) 30-330

PHA, PWM and ConA stimulation was normal

January 5, 2015

Absolute Lymphocytes L 1559 (cells/uL) 4000-13500

Absolute Cd3+ Cells L 754 (cells/uL) 2160-5540

Absolute Cd4+ Cells L 547 (cells/uL) 1390-4080

Absolute Cd8+ Cells L 222 (cells/uL) 600-1490

Absolute Nk Cells (cd16+cd56+cells) 184 (cells/uL) 160-930

Absolute Cd19+ Cells L 519 (cells/uL) 740-2560

 Thanks,
Richard
--
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788<tel:%28972%29%20566-7788>
Fax (972) 566-8837<tel:%28972%29%20566-8837>
Cell (214) 697-7211<tel:%28214%29%20697-7211>

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095<tel:%2B1.414.224.8095>
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://urldefense.proofpoint.com/v2/url?u=https-3A__cis.execinc.com_edibo_Signup&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=6LYdpolEon44yD8hAIIooeNjYmJjTJq5ab_KkaLaSF4&e=> to join!

You are currently subscribed to cis-pidd as: cooper_m at kids.wustl.edu<mailto:cooper_m at kids.wustl.edu>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824437.a01dbcff8dbb085c637e24ff0142df85&n=T&l=cis-pidd&o=45917375<https://urldefense.proofpoint.com/v2/url?u=http-3A__lm.clinimmsoc.org_u-3Fid-3D183824437.a01dbcff8dbb085c637e24ff0142df85-26n-3DT-26l-3Dcis-2Dpidd-26o-3D45917375&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=GUwwcoYwMnh_9mhGMGq18vZsPdwmoo7U58B3Zmxe02A&e=>

The materials in this email are private and may contain Protected Health Information. If you are not the intended recipient, be advised that any unauthorized use, disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error, please immediately notify the sender via telephone or return email.

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095<tel:%2B1.414.224.8095>
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://urldefense.proofpoint.com/v2/url?u=https-3A__cis.execinc.com_edibo_Signup&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=6LYdpolEon44yD8hAIIooeNjYmJjTJq5ab_KkaLaSF4&e=> to join!

You are currently subscribed to cis-pidd as: drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824791.4055848875ac55142db7b13469f6d1ab&n=T&l=cis-pidd&o=45917464<https://urldefense.proofpoint.com/v2/url?u=http-3A__lm.clinimmsoc.org_u-3Fid-3D183824791.4055848875ac55142db7b13469f6d1ab-26n-3DT-26l-3Dcis-2Dpidd-26o-3D45917464&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=NsnJ208Pi-9JWa9ApHbNVgEdkUhe4L9f8sLQfCzZczE&e=>

--
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

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://urldefense.proofpoint.com/v2/url?u=https-3A__cis.execinc.com_edibo_Signup&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=6LYdpolEon44yD8hAIIooeNjYmJjTJq5ab_KkaLaSF4&e=> to join!

You are currently subscribed to cis-pidd as: dhconway at hotmail.com<mailto:dhconway at hotmail.com>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824436.ff92e3b04ea7d4047458ee3ec0fc8f24&n=T&l=cis-pidd&o=45917513<https://urldefense.proofpoint.com/v2/url?u=http-3A__lm.clinimmsoc.org_u-3Fid-3D183824436.ff92e3b04ea7d4047458ee3ec0fc8f24-26n-3DT-26l-3Dcis-2Dpidd-26o-3D45917513&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=8wgMLpPWA95SVwMKjpkfR8VD-Qhga-2aON04v-uChtI&e=>

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org<https://urldefense.proofpoint.com/v2/url?u=https-3A__cis.execinc.com_edibo_Signup&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=6LYdpolEon44yD8hAIIooeNjYmJjTJq5ab_KkaLaSF4&e=> to join!

You are currently subscribed to cis-pidd as: mkeller at childrensnational.org<mailto:mkeller at childrensnational.org>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=202536700.bba161e2ff9c9e1b35b1386869d41ea1&n=T&l=cis-pidd&o=45917644<https://urldefense.proofpoint.com/v2/url?u=http-3A__lm.clinimmsoc.org_u-3Fid-3D202536700.bba161e2ff9c9e1b35b1386869d41ea1-26n-3DT-26l-3Dcis-2Dpidd-26o-3D45917644&d=AwMGaQ&c=Zoipt4Nmcnjorr_6TBHi1A&r=mERX_I8PKb0Uil9coedoT1CtvFqkSey45L0vbcX0oKI&m=XDGSt8E3aO2CwaJ0M_VDcJls09j3vHlFlqcXCgBuKWw&s=qXV_0-CVCO0Wupp_evfKP1vCaRarqSLyot9f_YCrcd0&e=>

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183939985.3ea13d40a15475ac00ebbd9cd8a37d6d&n=T&l=cis-pidd&o=45919070
or send a blank email to leave-45919070-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://pairlist7.pair.net/pipermail/pagid/attachments/20150107/6e186887/attachment-0001.html>