Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report
Chenxi Yan, Junke Qiu, Xiaohong Pan, Xiaoqin Huang, Lei Pan, Caihong Wang, Minjie Mao Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang, 310003, People’s Republic of ChinaCorrespondence: Minjie Mao, Zhejiang Provincial Hospital of Integrated Traditional Ch...
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Dove Medical Press
2025-01-01
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| author | Yan C Qiu J Pan X Huang X Pan L Wang C Mao M |
| author_facet | Yan C Qiu J Pan X Huang X Pan L Wang C Mao M |
| author_sort | Yan C |
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| description | Chenxi Yan, Junke Qiu, Xiaohong Pan, Xiaoqin Huang, Lei Pan, Caihong Wang, Minjie Mao Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang, 310003, People’s Republic of ChinaCorrespondence: Minjie Mao, Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine, 208 huancheng East Road, Gongshu District, Hangzhou, 310003, People’s Republic of China, Tel +86 15825500408, Email maominjie0909@163.comAbstract: Patients with selective IgA deficiency could have various clinical presentations ranging from asymptomatic to severe respiratory or gastrointestinal tract infection, as well as autoimmune disease and allergic reactions. Selective IgA deficiency is relatively common in Caucasians, but it is rare in the Asian population, meaning it could be easily missed in the clinic. In this study, we report a 26-year-old man with a history of asthma and nephrotic syndrome. He presented with symptoms of pulmonary infection, and his condition quickly deteriorated to respiratory failure that required endotracheal intubation and mechanical ventilation. Sputum smear; sputum, blood, and bronchoalveolar lavage fluid culture; and metagenomic sequencing examination identified multiple mixed pathogens, including Mycobacterium chelonae-abscessus, Pseudomonas aeruginosa, Candida parapsilosis, Acinetobacter baumannii, and Klebsiella cepacia. Finally, he was diagnosed with selective IgA deficiency after a laboratory test detected an extremely low serum IgA level (< 0.06 g/L). The patient died of septic shock and multiorgan failure despite aggressive management with a combination of antibiotics and supportive care. We report this case to remind clinicians about this rare disease in the Asian population. Patients with multisystem illnesses that are related to immune dysregulation, such as asthma or nephrotic syndrome, should be tested for immune system disorder. Rare and mixed pathogens should be considered during antibiotic selection in patients with selective IgA deficiency.Keywords: selective IgA deficiency, asthma, nephrotic syndrome, pulmonary infection |
| format | Article |
| id | doaj-art-ef50ac40054f4d1c9aab885c786112fa |
| institution | Kabale University |
| issn | 1178-7031 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Inflammation Research |
| spelling | doaj-art-ef50ac40054f4d1c9aab885c786112fa2025-01-07T16:42:40ZengDove Medical PressJournal of Inflammation Research1178-70312025-01-01Volume 1812713298981Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case ReportYan CQiu JPan XHuang XPan LWang CMao MChenxi Yan, Junke Qiu, Xiaohong Pan, Xiaoqin Huang, Lei Pan, Caihong Wang, Minjie Mao Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang, 310003, People’s Republic of ChinaCorrespondence: Minjie Mao, Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine, 208 huancheng East Road, Gongshu District, Hangzhou, 310003, People’s Republic of China, Tel +86 15825500408, Email maominjie0909@163.comAbstract: Patients with selective IgA deficiency could have various clinical presentations ranging from asymptomatic to severe respiratory or gastrointestinal tract infection, as well as autoimmune disease and allergic reactions. Selective IgA deficiency is relatively common in Caucasians, but it is rare in the Asian population, meaning it could be easily missed in the clinic. In this study, we report a 26-year-old man with a history of asthma and nephrotic syndrome. He presented with symptoms of pulmonary infection, and his condition quickly deteriorated to respiratory failure that required endotracheal intubation and mechanical ventilation. Sputum smear; sputum, blood, and bronchoalveolar lavage fluid culture; and metagenomic sequencing examination identified multiple mixed pathogens, including Mycobacterium chelonae-abscessus, Pseudomonas aeruginosa, Candida parapsilosis, Acinetobacter baumannii, and Klebsiella cepacia. Finally, he was diagnosed with selective IgA deficiency after a laboratory test detected an extremely low serum IgA level (< 0.06 g/L). The patient died of septic shock and multiorgan failure despite aggressive management with a combination of antibiotics and supportive care. We report this case to remind clinicians about this rare disease in the Asian population. Patients with multisystem illnesses that are related to immune dysregulation, such as asthma or nephrotic syndrome, should be tested for immune system disorder. Rare and mixed pathogens should be considered during antibiotic selection in patients with selective IgA deficiency.Keywords: selective IgA deficiency, asthma, nephrotic syndrome, pulmonary infectionhttps://www.dovepress.com/mixed-pulmonary-infection-asthma-and-nephrotic-syndrome-in-a-patient-d-peer-reviewed-fulltext-article-JIRselective iga deficiencyasthmanephrotic syndromepulmonary infection |
| spellingShingle | Yan C Qiu J Pan X Huang X Pan L Wang C Mao M Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report Journal of Inflammation Research selective iga deficiency asthma nephrotic syndrome pulmonary infection |
| title | Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report |
| title_full | Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report |
| title_fullStr | Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report |
| title_full_unstemmed | Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report |
| title_short | Mixed Pulmonary Infection, Asthma, and Nephrotic Syndrome in a Patient Diagnosed with Selective IgA Deficiency: A Case Report |
| title_sort | mixed pulmonary infection asthma and nephrotic syndrome in a patient diagnosed with selective iga deficiency a case report |
| topic | selective iga deficiency asthma nephrotic syndrome pulmonary infection |
| url | https://www.dovepress.com/mixed-pulmonary-infection-asthma-and-nephrotic-syndrome-in-a-patient-d-peer-reviewed-fulltext-article-JIR |
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