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Question :

Posted On : 21 Oct 2004

32 month old male with pneumonia and fever three times in the last six months. Serum IgG=570, serumIgA=39. How to manage further?

Expert Answer :

No expert answer available.

Answer Discussion :

Amy

intravenous antiboitics

20 years ago

pediatriconcall

Since he has repeated LRTI, one would like to rule out the following:

1. Congenital lung malforamtion {Especially if one lung is predominantly affectd}
2. GER {if the right side is predominantly affected.}
3. Cystic fibrosis {ABG would show metabloic alkalosis and he would be malnourished}
4. Underlying immunodeficiency {which seems likely since his serum IgG and IgA are low}
5. Asthma {if causing wheezing and improves with beta agonists}
6. Foreign body

You need to consult a pediatric immunologist as his immunity is low and if he is very symptomatic hypogammaglobulinemia should be ruled out. If he has hypogammaglobulinemia, treatment would be Intravenous immunoglobulin monthly.

20 years ago

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