Indiana University Infectious Diseases Fellowship
2 Feb,
5 tweets, 3 min read
#idboardreview 50 M recent recurrent frequent bronchitis and recent bacterial pneumonia & sinusitis is found to have IgG 200⬇️, IgA 400 & IgM 150. Diagnosis? #medEd #idmedEd #idtwitter 
#CVID common variable immunodeficiency: recurrent bacterial infections+ low IgG levels. Low IgG can frequently be seen in smokers or others with bronchial damage. Patient needs further evaluation
Low IgG: check specific antibody titers before&after immunization to check ability to produce antibody on appropriate antigen stimulation. Random titers not helpful. If already on IgG: Novel antigen like keyhole limpet hemocyanin or bacteriphage 174 can be checked
#CVID primary immunodeficiency: impaired B cell differentiation w/ defective immunoglobulin production. Most prevalent form of severe antibody deficiency. "Variable" refers to heterogeneous clinic picture: recurrent infections, chronic lung dz, autoimmune/GI dz & ⬆️lymphoma risk
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