A 1-Year-Old Boy Is Evaluated for a Suspected Immune Deficiency

question 4

Multiple Choice

A 1-year-old boy is evaluated for a suspected immune deficiency.He has a history since birth of eczema,recurrent rashes,and diarrhea.(Normal values are given in parentheses.) His WBC count is 6.75/uL (5.0-10.8 × 10³ uL) with a normal differential.Platelet count is 35,000 (150,000-350,000/uL) and the platelets are small.His IgG is 750 mg/dL (600-1,500 mg/dL) ,IgM is 30 mg/dL (75-150 mg/d:) ,IgA is 475 mg/dL (50-125 mg/dL) ,and IgE is 750 mg/dL (10-50 mg/dL) .The boy's blood is typed as O-positive,and he does not have anti-A or anti-B antibodies.Flow cytometry performed on his blood shows 11% (5-20%) CD19 and 50% (60-80%) CD3 cells with a normal ratio of CD4:CD8.T-cell function tests are abnormal.This boy most likely has:

• A) Bruton's hypogammaglobulinemia
• B) Wiskott-Aldrich syndrome
• C) DiGeorge syndrome
• D) ataxia telangiectasia

---

Definitions:

Union

An organization of workers formed to protect and advance their rights and interests; also refers to the act of uniting or the state of being united.

Income Tax

A tax imposed by the government directly on individuals' or entities' income.

Lincoln

The 16th President of the United States, Abraham Lincoln, who led the nation during the Civil War and is known for issuing the Emancipation Proclamation.