الوصف الكامل Background
A 29-year-old woman developed herpes zoster and lobar pneumonia.
القصة المرضية HPI
Over the next 5 years, she was admitted to hospital with pneumonia on four occasions and yet there had been no history of recurrent chest infections during childhood. .
السوابق المرضية الشخصية PMH
At the age of 33, she developed a non-erosive seronegative arthritis. On direct questioning, she gave a history of intermittent diarrhoea since her late teens. Her bowel upsets lasted from 2 days to 2 weeks and during this time she passed five to six partly formed stools a day.
السوابق المرضية العائلية FMH
There was no family history of recurrent infections:
الوضع الصحي والاجتماعي SH
she had two sons, aged 10 and 7, both of whom were well.
الفحص السريري Clinical Exam
Physical examination was normal though she was thin
Investigations showed a haemoglobin of 115g/l with a normal white-cell count and differential. Immunological studies (Table C3.2) showed marked hypogammaglobulinaemia and no specific antibodies, despite a tetanus toxoid boost 1 year earlier. She had normal numbers of T and B lymphocytes. Antinuclear antibodies and rheumatoid factor were not detected. Investigations into the cause of her recurrent diarrhoea revealed Giardia lamblia in the jejunal aspirate.
كتابة حرة وطرح موضوع النقاش!
what is the diagnose?
what is the Treatment in this case?