The Annals of Thoracic Surgery, Vol 22, 29-35, Copyright © 1976 by The Society of Thoracic Surgeons
Pulmonary complications in primary acquired hypogammaglobulinemia: surgical considerations
PM Ikins, JC Aust and WR Webb
With the discovery and routine use of antibiotics, a virtually new
disease--primary acquired hypogammaglobulinemia--was recognized. More
precise clinical, genetic, and laboratory endeavor has proved, in fact,
that it is really one of a whole host of individual disease entities, all
with the common feature of inadequate production and marshalling of gamma
globulin to combat infection. Although the condition has been recognized in
children's medicine for two decades, the survival of these early victims
into adolescence and adulthood is now bringing them to the attention of
surgeons as candidates for drainage or resection of suppurative disease of
the lung, air tubes, and pleura. In fact a triad has emerged, with some of
these patients having infectious disease in the lungs and sinuses
associated with enlargement of the spleen when first seen. Often it is the
radiologist who first suspects the diagnosis when he recognizes one or more
features of this diagnostic triad. Three personal cases are presented
together with a technique of management that appears successful. As with
the recognition of any new disease, occult and subclinical presentations
become more common as suspicion progresses, and ease of confirmation is
afforded.
