A Case of IgM Deficiency with B Cell Deficiency Detected by ABO Discrepancy in a Patient with Acute Osteomyelitis.
10.3343/alm.2013.33.3.208
- Author:
Chae Lim JUNG
1
;
Mi Kyung CHA
;
Byoung Hyuk JUN
;
Ki Sook HONG
Author Information
1. Department of Laboratory Medicine, Seoul Seonam Hospital, Ewha Womans University Medical Center, Seoul, Korea.
- Publication Type:Case Reports
- Keywords:
IgM deficiency;
B cell deficiency;
ABO discrepancy;
Acute osteomyelitis
- MeSH:
ABO Blood-Group System/genetics;
Acute Disease;
Adolescent;
B-Lymphocytes/cytology/immunology/metabolism;
Bone and Bones/radionuclide imaging;
Genotype;
Humans;
Immunoglobulin A/blood;
Immunoglobulin G/blood;
Immunoglobulin M/blood;
Immunologic Deficiency Syndromes/complications/*diagnosis;
Knee/radionuclide imaging;
Magnetic Resonance Imaging;
Male;
Osteomyelitis/complications/*diagnosis;
Radiopharmaceuticals/diagnostic use
- From:Annals of Laboratory Medicine
2013;33(3):208-211
- CountryRepublic of Korea
- Language:English
-
Abstract:
ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
