| Author | 8 Posts |
Perhaps
Forum Elite
Topics: 61
Posts: 162
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A 4-month-old boy is brought to the physician because of a 2-day history of fever and progressive redness around his right eye. He has had persistent diarrhea and oral candidiasis since birth and was treated for pneumococcal pneumonia at the age of 2 months. He appears ill. His temperature is 39 C (102.2 F), pulse is 130/min, and respirations are 25/min. Examination shows violaceous preseptal (periorbital) cellulitis and oral candidiasis. Laboratory studies show:
Hemoglobin 10 g/dL
Leukocyte count 3000/mm3
Segmented neutrophils 85%
Lymphocytes 15%
Platelet count 350,000/mm3
Serum
IgA <5 mg/dL
IgG 300 mg/dL
IgM <5 mg/dL
Which of the following is the most likely diagnosis?
A) AIDS
B) Chronic granulomatous disease
C) Severe combined immunodeficiency
D) Thymic-parathyroid dysplasia (DiGeorge syndrome)
E) X-linked agammaglobulinemia
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| djacosta
Forum Newbie
Topics: 1
Posts: 12
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SCID....
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| juanma0
Forum Senior
Topics: 10
Posts: 146
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Yep, I go with C, here´s why : A does not affect Basically T-cell, so there is no reason to have deficiency in al immunoglobulins. B. Typically has WBC in 10,000-20,000 w/60% PMN and produces abcesess and granulomas and is a inablility to produce oxidative burst not immunoglobulins. D. is another T-cell function disorder with different presentation, like tetany, heart disease etc. E. Typically occurs AFTER 6 months when maternal immunoglubulins decline, basically B-cell disorder, has intact T-cells. This patient has deficiency in all Ig´s and has recurrent infections since birth with all types of organisms, typicall of SCID which is the worst one of all these.
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| juanma0
Forum Senior
Topics: 10
Posts: 146
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Hey sorry, in my explanation of A, i meant does not affect immunoglobulins. Please coorect if wrong!
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| Perhaps
Forum Elite
Topics: 61
Posts: 162
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thanks a lot!
I agree C
Juanman0: nice explanaitions. 
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| jvo_md
Forum Senior
Topics: 22
Posts: 189
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Sorry guys, ill go with E
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| doc68
Forum Junior
Topics: 2
Posts: 56
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C, patient has fungal bacterial infections and looks like SCId
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
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i agree with C . fungal and becterial infections point towards a B a nd T cell defect. in X linked, bacterial infections and Giardia are common presentations. the most common form of SCID involves IL rcs and this is X linked too.
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