Postgraduate medical journal
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An 84 year old woman who was a heavy smoker presented with clinical features suggestive of acute exacerbation of chronic obstructive lung disease complicated by left ventricular failure. She responded poorly to treatment and then the finding of stridor, only when she was in the supine position, led to the diagnosis of a primary tracheal tumour, a rare but important cause of unexplained shortness of breath.
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Case Reports
Symptomatic IgG3 deficiency successfully treated with intravenous immunoglobulin therapy.
We report the case of a 35 year old female who presented with an 8 year history of repeated upper respiratory tract infection, lymphadenopathy and sinusitis associated with IgG3 deficiency. Courses of monthly intravenous immunoglobulin therapy (0.4 g/kg) resulted in a dramatic clinical improvement on three different occasions. We suggest that investigation of adults with features of immunosuppression, despite normal levels of total IgG, should include IgG3 subclass analysis and that symptomatic patients should be given a trial of immunoglobulin replacement therapy.