Table 1.

Findings at time of diagnosis

Reference valuesPatient 1Patient 2
Initial immune evaluation CD3 1,600–6,700 × 106/L 350 239 
CD4 1,000–4,600 × 106/L 129 179 
CD8 400–2,100 × 106/L 256 55 
CD19 600–2,700 × 106 14.4 
CD (15 + 56) 200–1,200 × 106/L 47 
RTE 900–5,800 × 106/L 20 30 
PHA (CD3 percentage) ≥60.8% 29.6% of control Not done 
IgG 1.3–6.8 g/L 9.2 9.5 
IgA ≤0.2 g/L 0.5 0.57 
IgM 0.2–0.9 g/L 0.53 2.5 
IgE ≤36 µg/L 93.4 93 
Anti-tetanus toxoid IgG <0.10 IU/ml indicates no detectable antibodies present 1.89 IU/ml 0.49 IU/ml 
Anti-diphtheria toxoid IgG <0.10 IU/ml indicates no detectable antibodies present 0.19 IU/ml 0.17 IU/ml 
Age of onset of symptoms ​ 4 years 6 mo 
Past infections at presentation ​ ​ Cellulitis, bullous impetigo, sinusitis, and 1 episode of shingles Recurrent sinopulmonary infections 
3 hospital admissions (between ages 8–11 mo): 
 Influenza A+ with superimposed bacterial pneumonia and bilateral AOM 
 Coronavirus OC43+ with pneumonia requiring i.v. antibiotics and oxygen supplementation 
 Rhinovirus+ with superimposed pneumonia requiring i.v. antibiotics and high-flow nasal cannula oxygen therapy 
Hearing impairment ​ None None 
Other complications ​ None Suspected pulmonary alveolar proteinosis (chronic lung changes) 
Neurodevelopmental complications ​ None None 
Age at diagnosis ​ 6 years 11 mo 
dAXP (% dAXP) at diagnosis (Duke University) <0.002 µmol/L (<0.2%) 0.293 µmol/L (13.8%) 0.358 µmol/L (18.1%) 
AXP at diagnosis (Duke University) 1.465 ± 0.38 µmol/L 1.829 µmol/L 1.625 µmol/L 
Deoxyadenosine at diagnosis (NSO) 0.1–0.4 µmol/L 15.1 µmol/L Not done 
Reference valuesPatient 1Patient 2
Initial immune evaluation CD3 1,600–6,700 × 106/L 350 239 
CD4 1,000–4,600 × 106/L 129 179 
CD8 400–2,100 × 106/L 256 55 
CD19 600–2,700 × 106 14.4 
CD (15 + 56) 200–1,200 × 106/L 47 
RTE 900–5,800 × 106/L 20 30 
PHA (CD3 percentage) ≥60.8% 29.6% of control Not done 
IgG 1.3–6.8 g/L 9.2 9.5 
IgA ≤0.2 g/L 0.5 0.57 
IgM 0.2–0.9 g/L 0.53 2.5 
IgE ≤36 µg/L 93.4 93 
Anti-tetanus toxoid IgG <0.10 IU/ml indicates no detectable antibodies present 1.89 IU/ml 0.49 IU/ml 
Anti-diphtheria toxoid IgG <0.10 IU/ml indicates no detectable antibodies present 0.19 IU/ml 0.17 IU/ml 
Age of onset of symptoms ​ 4 years 6 mo 
Past infections at presentation ​ ​ Cellulitis, bullous impetigo, sinusitis, and 1 episode of shingles Recurrent sinopulmonary infections 
3 hospital admissions (between ages 8–11 mo): 
 Influenza A+ with superimposed bacterial pneumonia and bilateral AOM 
 Coronavirus OC43+ with pneumonia requiring i.v. antibiotics and oxygen supplementation 
 Rhinovirus+ with superimposed pneumonia requiring i.v. antibiotics and high-flow nasal cannula oxygen therapy 
Hearing impairment ​ None None 
Other complications ​ None Suspected pulmonary alveolar proteinosis (chronic lung changes) 
Neurodevelopmental complications ​ None None 
Age at diagnosis ​ 6 years 11 mo 
dAXP (% dAXP) at diagnosis (Duke University) <0.002 µmol/L (<0.2%) 0.293 µmol/L (13.8%) 0.358 µmol/L (18.1%) 
AXP at diagnosis (Duke University) 1.465 ± 0.38 µmol/L 1.829 µmol/L 1.625 µmol/L 
Deoxyadenosine at diagnosis (NSO) 0.1–0.4 µmol/L 15.1 µmol/L Not done 

NSO, newborn screening Ontario; AXP, total adenosine nucleotides; % dAXP = [dAXP]/[AXP + dAXP] × 100; RTE, recent thymic emigrants; PHA, phytohemagglutinin (T cell mitogen used in lymphocyte proliferation assays).

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