Ann Lab Med.  2013 May;33(3):208-211. 10.3343/alm.2013.33.3.208.

A Case of IgM Deficiency with B Cell Deficiency Detected by ABO Discrepancy in a Patient with Acute Osteomyelitis

• Jung CL
• Cha MK
• Jun BH
• Hong KS

• KMID: 1781329
• DOI: http://doi.org/10.3343/alm.2013.33.3.208

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.

Keyword

IgM deficiency; B cell deficiency; ABO discrepancy; Acute osteomyelitis

MeSH Terms

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
ABO Blood-Group System
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Radiopharmaceuticals

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