Friday, November 21, 2008

Transient hypogammaglobulinemia of infancy

No, the title of the post wasn't me slamming my hands against my keyboard. That was the disease (well, not really a disease...) one of my patients had today.

The reason why I say it isn't really a disease is that transient hypogammaglobulinemia of infancy is a normal variant of the immune system of children. When born, babies have their mother's antibodies. As the months go on, those antibodies begin to fade, and the baby's own immune system is supposed to take over. Sometimes there's a bit of a lag between those two things happening, leaving the kid with low (hypo) antibodies (gammaglobulins). So, there are low levels of antibodies in the blood (-emia), you get hypogammaglobulinemia.

The kid today was a twin born at 34 weeks (remember from my OB posts, a full-term pregnancy is anything between 37-42 weeks). Since he didn't have as much time being fed from the placenta as he should have, he didn't have as much of his mother's antibodies as he could have used, which meant his levels got lower than they should have. At Ft. Knox (where he was born), he had several ear infections starting at 3 months old, which prompted a referral to the immunologist. He did blood tests and saw that there were low levels of antibodies, so he diagnosed transient hypogammaglobulinemia of infancy. Technically, the "transient" part can't be diagnosed until it goes away, which is why he's following up now--to get blood drawn again to check the levels. Since he hasn't had many infections in the last six or so months, we're pretty sure even before getting his blood that he has appropriate levels of antibodies for his age.

On a completely different note, I've mentioned a few times the hills of Tripler, so I included the elevation map (green line on the graph) of my usual run from my GPS watch. That loop takes me completely around base--like Walter Reed and unlike Madigan, Tripler is a stand-alone base, not part of a larger one. So it's a pretty small world I'm living in this month (obviously, as there's not even a place to buy food on base).

4 comments:

Dayna said...

I have a friend who was just diagnosed with Antiphospholipid Antibody Syndrome... not quite the mouthful that hypogammaglobulinemia is, but still a lot to type/write in the charts. I suppose that is why there are TLAs.

Unknown said...

Hmmm. Your pace didn't increase as you went down the hill. I suppose there is some medical reason for keeping an even pace?

Dayna said...

I had noticed the pacing too... For as steep as those hills were (or that one hill), you really didn't seem to have a slower pace either...

Lisa said...

I think it's a scale issue on the graph...either that, or the pace function on the Garmin isn't all that great. Actually, both explanations work.