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+--- Thread: Immuno, easy - pursuit (/showthread.php?tid=523121)
Immuno, easy - pursuit - ArchivalUser - 08-03-2010
A 30-year-old man consults a physician at his wife's insistence because "his eyes are a little yellow all the time now". Screening chemistry studies show modest elevations of liver transaminases and total bilirubin 2.0 mg/dL, almost all of which is conjugated. The patient denies ever using alcohol. Viral hepatitis studies are negative. Liver biopsy shows hepatic fibrosis with normal iron levels and no evidence for alpha-1-antitrypsin deficiency. On further questioning about his general health, the patient reveals that he has had an unusually large number of bacterial pneumonias in his life. He has even had Pneumocystis pneumonia at one point. HIV testing at that time and repeated twice since has always been negative. A doctor at the time had commented that he seemed to have some trouble making neutrophils. T and B cell numbers are within normal limits. Antibody studies reveal the following:
IgG total 200 mg/dL [normal 723-1685 mg/dL]
IgA 40 mg/dL [normal 81-463 mg/dL]
IgM 450 mg/dL [normal 48-271 mg/dL]
Which of the following is the most likely diagnosis?
A. Adenosine deaminase deficiency
B. Bruton's agammaglobulinemia
C. IgG subclass deficiency
D. Hyper IgM immunodeficiency
E. Selective IgA deficiency
2 - ArchivalUser - 08-03-2010
hyper IgM............ D
0 - ArchivalUser - 08-03-2010
yes D
0 - ArchivalUser - 08-05-2010
How is Burton's usually presented on the exam?
0 - ArchivalUser - 08-05-2010
How do they usually present Burton's on the exam?