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	<title>Immunodeficiency Syndrome - (  Bruton's agammaglobulinemia ) Child</title>
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	<pubDate>Wed, 19 Dec 2007 06:43:53 +0000</pubDate>
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		<title>Test Post</title>
		<link>http://sumit.healthblogs.org/2007/12/18/test-post/</link>
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		<pubDate>Wed, 19 Dec 2007 06:43:53 +0000</pubDate>
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			<content:encoded><![CDATA[<p>Test</p>
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		<title>Diagnosis of Immunodeficiency syndrome.- (  Bruton&#8217;s agammaglobulinemia ) Child</title>
		<link>http://sumit.healthblogs.org/2007/08/04/diagnosis-of-immunodeficiency-syndrome-brutons-agammaglobulinemia-child/</link>
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		<pubDate>Sat, 04 Aug 2007 15:52:02 +0000</pubDate>
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		<description><![CDATA[Diagnosis of Immunodeficiency syndrome. (   Bruton&#8217;s agammaglobulinemia ) Child.  
  
  
History of Present illness  
Patient : Tuhin sarkarAge  â‚¬&#8221; 4.5   year DOB  â‚¬&#8221; 25th Jan 2003Sex  â‚¬&#8221; MalePlace -
India  
Symptomatic  â‚¬&#8221; Since 7th month of life developed fever with loose stools, [...]]]></description>
			<content:encoded><![CDATA[<p><strong><font face="Times New Roman">Diagnosis of Immunodeficiency syndrome. ( <span>  </span></font></strong><strong><span>Bruton&#8217;s</span></strong><span> agammaglobulinemia </span><strong><font face="Times New Roman">) Child.</font></strong><strong><font face="Times New Roman">  </font></p>
<p></strong><strong><font face="Times New Roman">  </font></p>
<p></strong><strong><font face="Times New Roman">  </font></p>
<p></strong><strong><font face="Times New Roman">History of Present illness</font></strong><font face="Times New Roman">  </font></p>
<p><strong><font face="Times New Roman">Patient : Tuhin sarkar</font></strong><strong><font face="Times New Roman">Age  â‚¬&#8221; 4.5<span>   </span>year DOB  â‚¬&#8221; 25<sup>th</sup> Jan 2003</font></strong><strong><font face="Times New Roman">Sex  â‚¬&#8221; Male</font></strong><strong><font face="Times New Roman">Place -<br />
India</font></strong><font face="Times New Roman">  </font></p>
<p><font face="Times New Roman">Symptomatic  â‚¬&#8221; Since 7<sup>th</sup> month of life developed fever with loose stools, diagnosed as UTI with SEPSIS ( Ecoli Sepsis &amp; UTI ) another episode of fever with loose stool 15 days back. Same episode repeated given i/v antibiotics. 1 month later again the same episode got repeated, <strong>This time he was diagnosed Immunodeficiency syndrome. ( Brutons Ds).</strong></font><strong><font face="Times New Roman">  </font></p>
<p></strong></p>
<p class="MsoNormal"><font face="Times New Roman">Since then child started receiving regular IVIG infusions ( 5 gms per month ) along with Uroprophylesis ; now about two years back May 06 child started having symptoms of failure to thrive &amp; persistent cough. Child had multiple visits to hospital treated with oral as well as I/V antibiotics. Along with that for moderate degree of GERD. In view of persisting<span>   </span>Symptoms further work up was done which revealed growth hormone deficiency in year 2007 as probable cause for failure to thrive. Growth Harmone Supplement was started - Pfizer Genotropin. (1iu 6/7 )</font></p>
<p><font face="Times New Roman">  </font></p>
<p class="MsoNormal"><font face="Times New Roman">Now child has been admitted since 1/8/07<span>   </span>with increasing chest symptoms, unlike previous episode in once per month lasting for 3 -4 days and subsiding on oral augmentin &amp; nebulization , this admission had rapid downhill course from significant oxygen requirement to ventilation with respiratory paralysis. Currently he is<span>   </span>being ventilated at moderate pressures with FiO2 ~ 50%.</font></p>
<p><font face="Times New Roman">  </font></p>
<p class="MsoNormal"><font face="Times New Roman">Birth History &amp; Development  â‚¬&#8221; SIB Death at 1.5 year well thriving child died of ? Encephalitis<span>   </span>.</font></p>
<p class="MsoNormal"><font face="Times New Roman"><span>  </span><span>       </span></font></p>
<p><strong><font face="Times New Roman">Important Investigation  â‚¬&#8221; </font></strong></p>
<p class="MsoNormal"><span><font face="Times New Roman">                       </font></span></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="92" vAlign="top"><strong><font size="3" face="Times New Roman">  </font></p>
<p></strong></td>
<td width="107" vAlign="top"><strong><font size="3"><font face="Times New Roman">19/01/2004</font></font></strong></td>
<td width="102" vAlign="top"><strong><font size="3"><font face="Times New Roman">7.5.2005</font></font></strong></td>
<td width="102" vAlign="top"><strong><font size="3"><font face="Times New Roman">3/3/2007</font></font></strong></td>
<td width="104" vAlign="top"><strong><font size="3"><font face="Times New Roman">20.2.2007</font></font></strong></td>
<td width="83" vAlign="top"><strong><font size="3" face="Times New Roman">  </font></p>
<p></strong></td>
</tr>
<tr>
<td width="92" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">IgG</font></p>
</td>
<td width="107" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">5.525 g/L</font></p>
</td>
<td width="102" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 2.9 g/ L</font></p>
</td>
<td width="102" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 237 mg%</font></p>
</td>
<td width="83" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="92" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">IgA</font></p>
</td>
<td width="107" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 0.221 g/L</font></p>
</td>
<td width="102" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 0.2 g/L</font></p>
</td>
<td width="102" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 37 mg%</font></p>
</td>
<td width="83" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="92" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">IgM</font></p>
</td>
<td width="107" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 0.168 g/L</font></p>
</td>
<td width="102" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 0.23 g/L</font></p>
</td>
<td width="102" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&lt; 20 mg%</font></p>
</td>
<td width="83" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="104" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top"><strong><font size="3"><font face="Times New Roman">20  â‚¬&#8221; 27 /2/ 2007</font></font></strong></td>
<td width="93" vAlign="top"><strong><font size="3"><font face="Times New Roman">13.6.07</font></font></strong></td>
</tr>
<tr>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">DMSA</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Bilaterally good cortical function and no evidence of cortical scarring</font></p>
</td>
<td width="93" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Bilaterally good cortical function and no evidence of cortical scarring</font></p>
</td>
</tr>
<tr>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">DTPA</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Bilaterally good cortical with unobstructed drainage</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">MCU</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Normal Study</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">GER</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Scintigraphic findings are suggestive of presence of mild GER in the study</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="104" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">HRCT</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="113" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Normal Study</font></p>
</td>
<td width="93" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<p><font face="Times New Roman">  </font></p>
<p><font face="Times New Roman">  </font></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="118" vAlign="top"><strong><font size="3"><font face="Times New Roman">Date</font></font></strong></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><strong><font size="3"><font face="Times New Roman">3.3.07</font></font></strong></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Sweat Chloride</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">47 mEq/lt</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Mutational Analysis</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Stool for Fats ( Fat Globules)</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">&gt; 200 / HPF</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Deuodenal Biopsy</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">T3 / T4 / TSH</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">1.92 / 134.1 / 1.72</font></p>
</td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<table border="1" cellPadding="0" cellSpacing="0" class="MsoTableGrid">
<tr>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">USG</font></p>
</td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top"><font size="3" face="Times New Roman">  </font></td>
<td width="118" vAlign="top">
<p class="MsoNormal"><font size="3" face="Times New Roman">Normal Study</font></p>
</td>
</tr>
</table>
<p><font face="Times New Roman">  </font></p>
<p>  <font face="Times New Roman">Please suggest course of medication and medicines</font></p>
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		<title>Hello world!</title>
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		<pubDate>Sat, 04 Aug 2007 15:36:09 +0000</pubDate>
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