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_NO TOC_
_NOTOC _
{{CMG}};{{AE}}{{Vbe}}
{{CMG}};{{AE}}{{Vbe}}
== Hyperventilation ==
 
{| class="wikitable"
==Causes==
! rowspan="3" |Organ system
[[Hypogammaglobulinemia]] is caused by:
! rowspan="3" |Diseases
 
! colspan="9" |Clinical manifestations
Immunodeficiency secondary to:
! colspan="5" rowspan="2" |Diagnosis
*[[Uremia]]
! rowspan="3" |Other features
*Protein losing enteropathy
|-
*[[Nephrotic syndrome]]
! colspan="4" |Symptoms
*Malnutrition
! colspan="5" |Physical exam
*Cirrhosis
|-
*Hemodialysis
!Chest pain
* Intestinal lymphangiectasia
!Dyspnea
 
!Fever
* Protein-losing gastroenteropathy
!Palpitations
*[[Nephrotic syndrome]]
!Cyanosis
*[[Thymoma]] <ref name="pmid29881497">{{cite journal |vauthors=Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD |title=[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome] |language=French |journal=Pan Afr Med J |volume=28 |issue= |pages=253 |date=2017 |pmid=29881497 |pmc=5989270 |doi=10.11604/pamj.2017.28.253.11352 |url=}}</ref>
!Tachypnea
* Medications :
!JVD
** Gold
!Peripheral edema
**D-Penicillamine
!Ascultation
**Sulfasalazin
!ABGs
**Anticonvulsants
!Lab findings
**Glucocorticoids
!Imaging
**Methotrexate
!PFT
**Calcineurin inhibitors
!Gold standard
** Rituximab<ref name="pmid29755528">{{cite journal |vauthors=Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M |title=Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura |journal=Case Rep Med |volume=2018 |issue= |pages=2096186 |date=2018 |pmid=29755528 |pmc=5884289 |doi=10.1155/2018/2096186 |url=}}</ref><ref name="pmid29752554">{{cite journal |vauthors=Farhat L, Dara J, Duberstein S, De A |title=Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report |journal=Drug Saf Case Rep |volume=5 |issue=1 |pages=22 |date=May 2018 |pmid=29752554 |pmc=5948191 |doi=10.1007/s40800-018-0087-y |url=}}</ref><ref name="pmid29627491">{{cite journal |vauthors=Thorlacius H, Jerkeman A, Marginean FE, Toth E |title=Colorectal malakoplakia in a patient with hypogammaglobulinemia |journal=Gastrointest. Endosc. |volume= |issue= |pages= |date=April 2018 |pmid=29627491 |doi=10.1016/j.gie.2018.04.001 |url=}}</ref>
|-
 
! rowspan="8" |Pulmonary system
* Environmental hazards:
!Pneumothorax
** Ionizing radiation
!+
**Toxins
!+
 
!+
*Infections
!+
** Viral(Herpes, Measles)
!+
**Bacterial(Mycobacterial)
!+
**Parasitic(Malaria, helminthic infections)
!_
!_
!Decreased breath sounds
!
!
!X- ray - Mediastinal shift, deep sulcus sign, hydropneumothorax
CT-scan- Bullae
!
! CT-scan
! Hypoxia, Hypercapnia, Hyperesonance to percussion, Vocal resonance and Tactile fremitus decreased
|-
!Pulmonary embolism
!+
!+
!+
!+
!+
!+
!
!
!
!
!
!
!
!
!
|-
!Pneumonia
!+
!+
!+
!+
!+
!+
!-
!-
!Bronchial breath sounds, crepitations, bronchophony, egophony, whispering pectoroloqy
!
! CBC, Blood culture, Mantoux test, Serology (mycoplasma, viruses), Sputum: Gram stain and culture
! CXR- Lobar consolidation, air bronchogram; Atypical pneumonia: Diffuse interstitial infiltrates
!
!
!
!
!
|-
!Exacerbation of asthma/COPD
!-
!+
!-
!+
!+
!+
!-
!-
!Decreased breath sounds, wheezing, coarse crackles
!Increased PaCo2, Decreased PaO2
!CBC- Increased hematocrit from chronic hypoxia, Sputum evaluation, BNP( to rule out heart failure)
!X- ray: Hyperinflated lungs, flattening of the diaphragm, narrow heart shadow, cardiomegaly
!Increased TLC, Increased RV, Decreased Vital capacity, Decreased DLco ( Emphysema), and Normal DLco ( Chronic bronchitis)
! HRCT ( High resolution computed tomography of the lung)
! Productive cough, Exercise intolerance, Altered mental status, Cor-pulmonale, Hyperresonance on percussion
|-
!Interstitial lung disease
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Intrapulmonary shunt
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Upper airway obstruction
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!High altitude sickness
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="4" |Cardiovascular system
!Acute coronary syndrome
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Heart failure
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Dysrhythmias
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Shock
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="3" |Metabolic/Systemic disorders
!Diabetic ketoacidosis
!
!
!
!
!
!
!
!
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!
!
!
!
|-
!Hypocalcemia
!
!
!
!
!
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!
!
!
!
!
!
!
!
!
|-
!Hypoglycemia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
! rowspan="2" |Endocrine system
!Hyperthyroidism
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Pheochromocytoma
!
!
!
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!
!
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!
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!
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!
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|-
! rowspan="2" |CNS
!Central nervous system tumor
!
!
!
!
!
!
!
!
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!
!
!
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!
!
|-
!Anxiety/panic attacks
!
!
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!
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|-
! rowspan="3" |Others
!Pregnancy
!
!
!
!
!
!
!
!
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!
!
|-
!Hepatic failure
!
!
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!Sepsis
!
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|}

Latest revision as of 14:23, 3 August 2018


_NOTOC _ Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Causes

Hypogammaglobulinemia is caused by:

Immunodeficiency secondary to:

  • Protein-losing gastroenteropathy
  • Nephrotic syndrome
  • Thymoma [1]
  • Medications :
    • Gold
    • D-Penicillamine
    • Sulfasalazin
    • Anticonvulsants
    • Glucocorticoids
    • Methotrexate
    • Calcineurin inhibitors
    • Rituximab[2][3][4]
  • Environmental hazards:
    • Ionizing radiation
    • Toxins
  • Infections
    • Viral(Herpes, Measles)
    • Bacterial(Mycobacterial)
    • Parasitic(Malaria, helminthic infections)
  1. ↑ Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD (2017). "[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome]". Pan Afr Med J (in French). 28: 253. doi:10.11604/pamj.2017.28.253.11352. PMC 5989270. PMID 29881497.
  2. ↑ Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M (2018). "Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura". Case Rep Med. 2018: 2096186. doi:10.1155/2018/2096186. PMC 5884289. PMID 29755528.
  3. ↑ Farhat L, Dara J, Duberstein S, De A (May 2018). "Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report". Drug Saf Case Rep. 5 (1): 22. doi:10.1007/s40800-018-0087-y. PMC 5948191. PMID 29752554.
  4. ↑ Thorlacius H, Jerkeman A, Marginean FE, Toth E (April 2018). "Colorectal malakoplakia in a patient with hypogammaglobulinemia". Gastrointest. Endosc. doi:10.1016/j.gie.2018.04.001. PMID 29627491.
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