Hyper-IgM syndrome

• Facts:
  High levels of IgM, with deficiency of IgG, IgA, and poor specific antibody responses to immunizations
• History / PE:
  Recurrent sinopulmonary infections
  Pneumocystis jiroveci penumonia
• Diagnosis:
  Elevated IgM and low IgG, IgA
  Neutropenia
• Differential Diagnosis:
  Common variable immunodeficiency (older patients)
  Bruton's agammaglobulinemia (deficiency of ALL Ig)