**Core Concept**
The given immunologic abnormalities suggest an underlying defect in cell-mediated immunity, characterized by decreased T-cell function. This is accompanied by a specific pattern of immunoglobulin levels, where IgG and IgA are normal, but IgM is elevated. These findings are indicative of DiGeorge syndrome, a congenital condition caused by thymic hypoplasia or aplasia, leading to impaired T-cell development and function.
**Why the Correct Answer is Right**
The decreased T-cell function in DiGeorge syndrome results from impaired thymic development, which is crucial for T-cell maturation. The absence or hypoplasia of the thymus gland leads to a deficiency in T-cell production, causing a range of immunologic abnormalities. The elevated IgM levels are a consequence of the decreased T-cell function, as IgM is primarily produced by B cells, which are not as heavily affected by the T-cell deficiency. The normal IgG and IgA levels suggest that B-cell function is relatively preserved.
**Why Each Wrong Option is Incorrect**
**Option A:** This option might be considered if the patient had a more generalized immunodeficiency, such as severe combined immunodeficiency (SCID), which would typically present with low levels of all immunoglobulins.
**Option B:** This option could be considered if the patient had a primary B-cell immunodeficiency, such as X-linked agammaglobulinemia, which would typically present with low levels of all immunoglobulins.
**Option C:** This option might be considered if the patient had a secondary immunodeficiency, such as one caused by chronic illness or malnutrition, which would typically present with a broader range of immunologic abnormalities.
**Clinical Pearl / High-Yield Fact**
DiGeorge syndrome is characterized by a classic triad of clinical features: congenital heart disease, cleft palate, and hypocalcemia. The hypocalcemia is due to parathyroid gland hypoplasia or aplasia, which is often associated with the thymic hypoplasia.
**Correct Answer:** C. DiGeorge syndrome.
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