What is the role of imaging studies in the workup of agammaglobulinemia (hypogammaglobulinemia)?

Updated: Jul 08, 2019
  • Author: Donald A Person, MD, FAAP, FACR; Chief Editor: Harumi Jyonouchi, MD  more...
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Answer

No radiological findings are specific for agammaglobulinemia, although it is suggested by an absence of adenoidal tissue (eg, adenoidal tissue in lateral head films to evaluate chronic sinusitis). Chest radiography findings of unexplained bronchiectasis should also lead to an evaluation of the patient's immune status.

CT scanning of the sinuses and the lungs is more effective than plain radiography in documenting disease progression in these locations. High-resolution CT scanning of the chest is helpful to delineate the extent of lung damage. One study found bronchiectasis in 58% patients with agammaglobulinemia. [67]

Their presence appears to increase the likelihood of pneumonia and decreasing lung function.

Sinus CT examinations may be required as clinically needed. [67]

Some physicians advocate using MRI of the brain in patients with agammaglobulinemia or hypogammaglobulinemia who develop unexplained neurological symptoms and signs of meningeal inflammation, despite extensive investigation of cerebrospinal fluid (CSF), including polymerase chain reaction (PCR) analyses.

Delayed bone age is evident in patients with growth hormone deficiency.


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