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Recurrent sinusitis + viral respiratory infection in a boy

2K views 11 replies 10 participants last post by  m82_ghasemi 
#1 ·
An 8-year-old white male is brought to your office by his parents, who are concerned about the number of colds he has had. Your chart review indicates that he has had approximately 15 URI’s each year. Most were viral, but he has also had several episodes of sinusitis. Family history reveals that the mother has similar problems and has recently been diagnosed with rheumatoid arthritis. The most likely immune deficiency in this child is?

A) Bruton’s panhypogammaglobulinemia
B) DiGeorge’s syndrome
C) Wiskott-Aldrich syndrome
D) Combined immunodeficiency
E) selective IgA deficiency

Please answer it with explanation!
 
#2 ·
I'll go with B) DiGeorge's syndrome

Reason: Thymic aplasia will have dec T cell maturation (as we know T cell matures at Thymus). So less cytotoxic T cells --> which are good against virus. So more viral inf.

SCID is also a good option but SCID are usually present with all viral, bacterial, fungal and protozoal.
 
#9 ·
selective IgA deficiency is the most common primary immune deficiency affecting 1:600 northern europeans. In most patients low or undetectable IgA is an incidental finding. 30 percent have recurrent mild respiratory and gastrointestinal infection. There is also a compensatory increase in serum IgG levels
 
#12 ·
Answer



ANSWER: E

Selective IgA deficiency is the most common primary immunodeficiency, occurring in up to 2% of the population. Although some patients may be asymptomatic, many are bothered by recurrent respiratory infections, chronic diarrheal syndromes, and a tendency to develop autoimmune diseases such as lupus erythromatosis or rheumatiod arthritis. The deficiency can be transmitted in an autosomal dominant pattern. The other immunodeficiencies listed are much less common, have other distinguishing characteristics, and are usually much more severe in nature
 
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