Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow?
A)
A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
B)
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
C)
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
D)
A 9-year-old girl who has a diagnosis of IgA deficiency
Ans:
B
Feedback:
Decreased IgA, IgE, and IgG with increased IgM levels are characteristic of X-linked immunodeficiency with hyper-IgM, a primary cell-mediated immunodeficiency that would respond to thymic tissue transplantation and MHC-compatible bone marrow. Low IgG levels secondary to phenytoin use, X-linked hypogammaglobulinemia, and selective IgA deficiency are unlikely to be treated with the T-cell-focused treatments like thymic tissue transplantation and MHC-compatible bone marrow.
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