Case of Secondary antibody deficiency

A patient has secondary antibody deficiency due to B-cell suppression His primary pathology is likely to be

a) Waldenstrom macroglobulinemia
b) X-linked agammaglobulinemia
c) immunoglobulin A deficiency
d) immunoglobulin M deficiency
e) common variable immunodeficiency

The correct answer is A

Explanation
Antibody immunodeficiency can be primary or secondary. Secondary antibody deficiency due to B-cell suppression can occur with multiple myeloma, Waldenstrom macroglobulinemia, or chronic lymphocytic leukemia. Secondary deficiencies leave patients susceptible to the same pathogens that can cause recurrent pneumonia in patients with primary antibody deficiencies Primary antibody deficiencies include X-linked agammaglobulinemia, common variable immunodeficiency, selective immunoglobulin A or immunoglobulin M deficiency, and hyperimmunoglobulin M immunodeficiency. These disorders are characterized by chronic or recurrent pyogenic infection, especially pneumonia, caused by encapsulated bacteria (eg, S pneumoniae, H influenzae, and S aureus) and P aeruginosa . Untreated or recurrent pneumonia may lead to bronchiectasis.