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  #1  
Old 03-22-2012
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Question Repeated infections and no thymic shadow!

7-month old boy, white patches in his mouth (candidiasis). 2 episodes of otitis media in the past, 3 episodes of bronchiolitis. Loose stools. The child is small, ill-appearing. Upper airway transmitted sounds on the lung auscultation. Very low gamma-globulin level in serum, no thymic shadow on x-ray. Wtf is the diagnosis?

A. DiGeorge
B. SCID
C. X-linked agammaglobulinemia
D. CVID
E. Wiskott-Aldrich

answer - B. from UW, Q.Id: 1995 [394877]
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Old 03-22-2012
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B............?
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Old 03-22-2012
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No thymic shadow .. so A) DiGeorge's Syndrome ?
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Old 03-22-2012
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yes its B .......... SCID

very good Qs , it very easily tricks us into DiGeorge by saying absence of thymic shadow , but there is no Ig so bronchiolitis and otitis media ...

in
DiGeorge there is only T cell loss not Ig .......

I got it wrong , and was WTF Qs for me too ..............
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Old 03-22-2012
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answer is SCID (B) - Sign and sym - Failure to thrive , chronic diarrhea , infections - Low gammaglobulins and NO thymic shadow on xray.
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Old 03-22-2012
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Quote:
Originally Posted by Hitman View Post
yes its B .......... SCID

very good Qs , it very easily tricks us into DiGeorge by saying absence of thymic shadow , but there is no Ig so bronchiolitis and otitis media ...

in
DiGeorge there is only T cell loss not Ig .......

I got it wrong , and was WTF Qs for me too ..............
it got me with this "low gamma-globulins" so I thought they are still there, and it can't be scid.
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Old 07-13-2012
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Absence of thymic shadow occurs in ;

Bruton's - DiGeorge -and SCID... so it's not something really specific.
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Old 01-08-2014
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Default Thymus

FYI - the thymus is generally PRESENT in Brutons agammaglobulinemia but not in SCID.
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Old 01-08-2014
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People always overthink these questions :P. The Thymic shadow aspect can be misleading, but this question is very simple if you look at the symptoms. The child had a fungal, viral and bacterial infection. That's a combined B and T cell deficiency so it's gotta be SCID.
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