DrVirgo
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16. After a motorcycle collision, a 23-year-old man who is being transfused with erythrocytes and fresh frozen plasma has a systemic anaphylactic reaction. He has a history of recurrent respiratory tract infections. Blood hemoglobin concentration is 6.5 g/dL, and circulating B and T lymphocyte counts are normal. Which of the following is the most likely explanation of these findings?
A) AIDS
B) Common variable immunodeficiency
C) Drug-induced immunodeficiency
D) IgA deficiency
E) X-linked agammaglobulinemia
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| usmle99
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D? but there should also be a history of GI upset for IgA deficiency...
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| endocrine
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d
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| DrVirgo
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Does anyone have any ideas what the answer is?
B or D? and WHY
Thanks
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| alexaE
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its D- that would explain his reccurent respiratory tract infections, and at the same time remember that he is only deficient in IgA and the rest of his immunoglobulins are normal, so if given fresh plasma which still contains some IgAs from the donor, the patient will create his own antibodies against donor IgAs, hence the anaphylactic reaction
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| robin082006
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D for sure
Goljan mentions this.
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| DrVirgo
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You all are right... recurrent sinopulmonary infections...
develop anti IgA antibodies with exposure to blood products (danger of anaphylactic reaction when exposed to blood products with IgA)
thanks. 
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| waqastariq
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yups I agree with you all 
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