A young woman is experiencing persistent diarrhea that is at times bloody, and a nagging cough with shortness of breath. She has slight fever, but no rash. A blood test reveals normal leukocyte levels except for low levels of lymphocytes. Antibody titers are normal. The patient reports that she is currently monogamous, but previously "played around a bit," and her mother has SLE. Which immune system disorder is this information consistent with?

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Quizplus · Accepted Answer

The combination of persistent diarrhea (possibly caused by opportunistic infections in the gut), bloody stool (suggestive of gastrointestinal pathology), nagging cough (which may be due to a pulmonary infection or malignancy), shortness of breath (suggesting a possible pulmonary etiology), and low lymphocyte levels on blood work (which may indicate CD4+ T-cell depletion) are all suggestive of HIV/AIDS. The patient's previous sexual history also increases her risk for HIV acquisition. The absence of a rash makes the diagnosis of SLE less likely. Chronic granulomatous disease and Bruton-type agammaglobulinemia are primary immunodeficiency disorders that typically present earlier in life, whereas hypersensitivity pneumonitis is an allergic reaction to inhaled particles and would not explain the patient's other symptoms.

A Young Woman Is Experiencing Persistent Diarrhea That Is at Times