[CIS PIDD] [cis-pidd] quick question

Wed Jun 10 14:59:43 EDT 2015

Bodo,

The Boston Children's Hospital pediatric AI group (Tony Bonilla et al) hold a satellite clinic in Lexington, MA that is quite close to Burlington (about a 6 mile drive).

Boston Children's at Lexington
482 Bedford Street
Lexington, Massachusetts 02420
Contact:
781-216-2999
Fax:
781-216-2900

Best regards,
Alicia 

Alicia Johnston, M.D.
Baystate Medical Center
Springfield, MA 
--------------------------------------------
On Wed, 6/10/15, Bodo Grimbacher <bodo.grimbacher at uniklinik-freiburg.de> wrote:

 Subject: [cis-pidd] quick question
 To: "CIS-PIDD" <cis-pidd at lyris.dundee.net>
 Date: Wednesday, June 10, 2015, 2:27 PM

 Dear all,
 Is there a PID specialist near Burlington, MA 01805?
 A patient with rec. candidiasis requests to be seen...
 Thanks, Bodo
 ****************************************
 Univ.-Prof. Dr. med. B. Grimbacher

 Scientific-Director
 CCI-Center for Chronic Immunodeficiency
 UNIVERSITÄTSKLINIKUM FREIBURG
 Tel.: 0761 270-77731  Fax: -77744
 Engesserstraße 4, 79108 Freiburg
 bodo.grimbacher at uniklinik-freiburg.de
 www.uniklinik-freiburg.de/cci

 Am 09/06/15 20:13 schrieb "Dr. Jan Rohr" unter
 <jan.rohr at uniklinik-freiburg.de>:

 >Dear Rafael,
 >
 >I am not familiar with the gating strategy of your lab,
 but a
 >reference range down to 15% CD45RA+ cells in a 22 months
 old child
 >seems pretty low to me. In our lab the patient's value
 of 20% CD45RA
 >would be considered a pathologically low number at this
 age and thus
 >warrant further investigations. What is also somewhat
 odd is that the
 >percentages of CD45RA+ and CD45RO+ cells do not add to
 100% - what do
 >the remaining cell express if they are neither positive
 for CD45RA nor
 >for CD45RO ?
 >
 >May be worth to take a close look at the FACS plots.
 >
 >Kind regards,
 >
 >Jan
 >
 >
 >
 >Zitat von Rafael Firszt <Rafael.Firszt at hsc.utah.edu>:
 >
 >>
 >>
 >> I have a 22 month old with persistently borderline
 -mildly low CD8
 >>counts
 >> Clinically doing very well.  Very mild URI's
 only.  Developing
 >> normally and growing well.
 >> Tolerated Live viral vaccines.
 >> He was initially identified by newborn screen with
 low TRECS
 >> His immune parameters are below.
 >> He has normal CD45RA
 >>
 >> Ref. Range
 >>
 >> Units
 >>
 >> 06/05/15
 >> 12:10 *
 >>
 >> 08/13/14
 >> 12:15 [https://help2-lp.co.ihc.com/ResultsReview/images/note.gif]
 *
 >>
 >> 05/07/14
 >> 12:20
 >>
 >> 01/21/14
 >> 16:40 [https://help2-lp.co.ihc.com/ResultsReview/images/note.gif]
 >>
 >> Test Status
 >>
 >> Final
 >>
 >> Final
 >>
 >> Final
 >>
 >> Final
 >>
 >> % CD4 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 31-54
 >>
 >> %
 >>
 >> 30 L
 >>
 >> 30 L
 >>
 >> * 24 L
 >>
 >> * 25 L
 >>
 >> CD4, Abs Count  
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 1020-3600
 >>
 >> cells/uL
 >>
 >> 924 L
 >>
 >> 1096
 >>
 >> * 1002 L
 >>
 >> * 989 L
 >>
 >> % CD45RO 
 >>[https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 5-30
 >>
 >> %
 >>
 >> 11
 >>
 >> 7
 >>
 >> * 6
 >>
 >> * 7
 >>
 >> Absolute CD45RO 
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 50-1500
 >>
 >> cells/uL
 >>
 >> 299
 >>
 >> 239
 >>
 >> * 246
 >>
 >> * 263
 >>
 >> % CD45RA 
 >>[https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 15-70
 >>
 >> %
 >>
 >> 20
 >>
 >> 24
 >>
 >> * 19
 >>
 >> * 20
 >>
 >> Absolute CD45RA 
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 200-3400
 >>
 >> cells/uL
 >>
 >> 571
 >>
 >> 786
 >>
 >> * 810
 >>
 >> * 742
 >>
 >> CD4/CD8 Ratio   
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 1.17-6.62
 >>
 >> ratio
 >>
 >> 3.00
 >>
 >> 3.33
 >>
 >> * 3.00
 >>
 >> * 3.12
 >>
 >> % CD8 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 16-38
 >>
 >> %
 >>
 >> 10 L
 >>
 >> 9 L
 >>
 >> * 8 L
 >>
 >> * 8 L
 >>
 >> Absolute CD8 
 >>[https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 570-2230
 >>
 >> cells/uL
 >>
 >> 292 L
 >>
 >> 339 L
 >>
 >> * 326 L
 >>
 >> * 329 L
 >>
 >> % CD3 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 53-81
 >>
 >> %
 >>
 >> 43 L
 >>
 >> 40 L
 >>
 >> * 34 L
 >>
 >> * 34 L
 >>
 >> Absolute CD3 
 >>[https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 1460-5440
 >>
 >> cells/uL
 >>
 >> 1316 L
 >>
 >> 1483
 >>
 >> * 1373 L
 >>
 >> * 1349 L
 >>
 >> % CD19 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 11-45
 >>
 >> %
 >>
 >> 46 H
 >>
 >> 47 H
 >>
 >> * 49 H
 >>
 >> * 51 H
 >>
 >> Absolute CD19   
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 430-3300
 >>
 >> cells/uL
 >>
 >> 1381
 >>
 >> 1725
 >>
 >> * 2009
 >>
 >> * 2051
 >>
 >> % Natural Killer Cells
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 3-19
 >>
 >> %
 >>
 >> 9
 >>
 >> 11
 >>
 >> * 15
 >>
 >> * 13
 >>
 >> Absolute Natural Killer Cells
 >> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
 >>
 >> 80-340
 >>
 >> cells/uL
 >>
 >> 288
 >>
 >> 403 H
 >>
 >> * 621 H
 >>
 >> * 538 H
 >>
 >>
 >>
 >> In addition, he appears to have normal MHC I
 expression and normal
 >> NK function
 >>
 >> His IgG, M, A levels normal with very protective
 antibody titers.
 >> Normal lymphocyte mitogen assays.
 >>
 >>
 >> Should I be concerned?
 >>
 >>
 >> Thank you for your help.
 >>
 >> Rafael Firszt, MD
 >> University of Utah
 >>
 >>
 >>
 >>
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