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A 12-year-old girl presents with history of recurrent pneumonia, otitis media, and sinusitis. She has had bilateral perforated tympanic membranes and mild hearing loss. Chest radiograph reveals bronchiectasis at the left lower and right middle lobes and infiltration at right lower and upper lobes. Total serum IgG, IgA, and IgM levels are normal. Her immunizations are current. Which of the following laboratory tests is the most appropriate next step in this patient™s evaluation?
A)Total complement (CH50) and C3 and C4 levels
B)HIV serology
C)IgG subclass levels
D)Serum antibodies to tetanus toxoid and pneumococcal antigens
E)CD4/CD8 ratio
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genius waiting for this one
gane try again
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oh thnx 4 waiting okt3,i was doing som uw qs
is it A?
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D.Serum antibodies to tetanus toxoid and pneumococcal antigens. Patients with specific antibody deficiency frequently present with recurrent sinopulmonary infection with bacteria. Despite normal levels of total IgG, IgA, or IgM, patients with this deficiency are unable to produce antibodies to specific antigens (specific antibodies or functional antibodies). Evaluation of functional antibody production in patients who have received childhood immunizations should include measurement of serum antibodies to protein antigens (tetanus toxoid, diphtheria toxoid) and carbohydrate antigens (isohemagglutinins, pneumococcal polysaccharide antigens). Evaluation of antibody response to carbohydrate antigens should be performed using unconjugated pneumococcal vaccine (23-valent) since protein-conjugated polysaccharide antigens are recognized and processed by a subset of B cells that respond to protein antigens and they are different from the ones that respond to carbohydrate antigens.
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ok so that means that girl is unable to make antibodies against those vaccines given to her which r prots and carbohydrates?and overall there is no specific immune deficiency of as shown by normal levels of other antibodies.and what does the functional antibody mean?
thnx in advance!
