Immunodeficiency May be Diagnosed in Case of Hemoptysis

Abstract

Hemoptysis means coughing up blood from the respiratory system. In this study, a case, in which a patient was admitted with minor hemoptysis and then diagnosed with bronchiectasia and common variable immunodeficiency, was reported. A 11 year-old female patient admitted to our outpatient clinic with complaints of cough and coughing up blood. There was nothing particular in her background and family history. She had nothing particular in investigation of the systems. On her physical examination; her general condition was fine, she was conscious and fully cooperated. Her body temperature was 37.5 0C, heart rate 96/min, respiration rate 24/min and blood pressure 100/60 mmHg. Lungs were participating in respiration equally, respiration sounds were coarse. Examination of other systems were normal. In laboratory evaluation; in complete blood count: Hb: 13.1 g/dL, white blood cell count: 7700/mm3, platelets: 226 000/mm3 and C-reactive protein: 0.3 g/L. On posteroanterior chest x-ray, there was bilateral non-homogenously enhanced density. In fiberoptic bronchoscopy (FOB) performed for determination of the etiology; the right main bronchi were natural and small popular formations with yellowish-white pearl color, which were elevated from the skin and the mucosa in the region up to bronchial orifice of left lower lobe of the left main bronchus, were observed. Mucosa of the left lower lobe was hyperemic, some slightly mucopurulant secretions were aspirated from the left lower lobe; bronchi of left lower lobe were widened. In basal immunological work-ups of the patient; Ig A: 25.8 mg/dL (67-433), Ig G: 136 mg/dL (835-2094), Ig M: 20.5 mg/dL (47-484), Ig E: 18,7 IU/mL, isohemagglutinin:1/4, tetanus antibody: 0.01, pneumococcus antibody: 3 and Anti-HbS: 0. In the peripheral blood lymphocyte subgroup analysis, helper T-cell ratio was slightly reduced. As her immunological values were extremely low, an immunodeficiency was considered for the patient. For the patient common variable immunodeficiency was considered and a genetic test was planned to be sent.