A 9-year-old girl is brought to the office due to persistent nasal drainage. Over the past 2 weeks, the patient has had increasing nasal congestion and drainage. The discharge was initially clear but has become dark and foul smelling over the past few days. The patient has a history of multiple skin abscesses that developed when she was an infant, but they typically do not cause discomfort. She has also had atopic dermatitis since infancy. Temperature is 37.1 C (98.8 F). On examination, the patient is interactive and talkative. Thick nasal discharge appears from both nares. Cardiopulmonary examination is normal. There are several diffuse areas of dry, excoriated skin along the trunk and upper extremities. Results of a complete blood count are as follows: Which of the following patterns of immunoglobulin production is most likely to be seen in this patient?

Question

A 9-year-old girl is brought to the office due to persistent nasal drainage.  Over the past 2 weeks, the patient has had increasing nasal congestion and drainage.  The discharge was initially clear but has become dark and foul smelling over the past few days.  The patient has a history of multiple skin abscesses that developed when she was an infant, but they typically do not cause discomfort.  She has also had atopic dermatitis since infancy.  Temperature is 37.1 C (98.8 F).  On examination, the patient is interactive and talkative.  Thick nasal discharge appears from both nares.  Cardiopulmonary examination is normal.  There are several diffuse areas of dry, excoriated skin along the trunk and upper extremities.  Results of a complete blood count are as follows:  Which of the following patterns of immunoglobulin production is most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: Hyper-IgE syndrome is characterized by elevated IgE levels and is caused by impaired neutrophil activation and migration due to a defect in T-helper cell type 17 cells.  Typical findings include noninflammatory (ie, cold) abscesses, recurrent sinopulmonary infections, and chronic atopic dermatitis.

A 9-Year-Old Girl Is Brought to the Office Due to Persistent