The patient had a mild hypogammaglobulinemia
that could have been secondary to both his previous treatment and his immunodeficiency.
The immunologist suggested commencing the patient with immunoglobulin replacement therapy urgently, and the case was diagnosed as having severe hypogammaglobulinemia
most likely secondary to rituximab therapy.
Additionally, all the included patients fulfilled the following inclusion criteria: immunodeficiency onset at greater than two years of age, absence of isohemagglutinins, and absence of defined causes of hypogammaglobulinemia
. Those patients with profound T-cell deficiencies were excluded (CD4 number/microliter: 2-6 years <300, 6-12 years <250, and >12 years <200; % naive CD4: 2-6 years <25%, 6-16 years <20%, and >16 years 10%).
When the laboratory data were examined, it was found that two patients had lymphopenia (<2 000 /mm (3) ), three patients had anemia (<12 g/dL), five patients had slightly increased alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) level (>40 U/L, <100U/L), seven patients had increased C-reactive protein (CRP) level (>0.5 mg/dL), two patients had slightly decreased sodium level (130-135 mEq/L) and decreased potassium level (<3.5 mEq/L), three patients had decreased albumin level (<3.5 gr/dL) and one patient had hypogammaglobulinemia
at the time of presentation.
There was no context of neoplasia and serum protein electrophoresis showed no monoclonal peak or hypogammaglobulinemia
. The diagnosis of PHPT was confirmed by the dosage of PTH which was high in 4 cases with a mean value of 331 ng/L (199-536) and normal in a patient.
Another inadequate immune response that can be found in AD patients is hypogammaglobulinemia
. Studies reveal that hypogammaglobulinemia
is more frequent in patients with AD compared with the control groups, but it is not correlated with the severity of the skin disorder .
An example is the spontaneous chromothriptic cure of an individual with a rare congenital immunodeficiency disorder known as warts, hypogammaglobulinemia
, infections, and myelokathexis syndrome (WHIM), which is caused by mutations in the chemokine receptor CXCR4 gene.
, Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), immunodeficiency are the most prominent disease classes, collectively contributing about 53% of the global IVIG market revenue in 2014.
Total parenteral nutrition via a central venous catheter Lai 2010 Congenital short bowel Syndrome, hypogammaglobulinemia
, Porth-A-cath for total parenteral nutrition Becker 2008 Methylmalonic aciduria due to a noncobalamin- responsive deficiency of methylmalonyl coenzyme A mutase.
Patients were excluded if they were less than 18 years of age; had health care-acquired pneumonia, pneumonia associated with bronchial obstruction, bronchiectasis or known pulmonary tuberculosis, lung cancer, or severe immune suppression [severe neutropenia (<500/cc), long-term use of corticosteroids, transplantation of solid organ/bone marrow, use of immunosuppressant, hypogammaglobulinemia
, asplenia]; were pregnant; or experienced polytrauma.
The most common primary immunodeficiency disorders include selective IgA deficiency --which affects 1 in 500 children--Ig[G.sub.2] deficiency, transient hypogammaglobulinemia
of infancy, and DiGeorge anomaly, said Dr.