Answer to case 7

Bruton's disease (X-linked agammaglobulinemia)is a form of primary immunodeficiency. In this disease pre-B cells fails to differentiate into immature B cells in the bone marrow due to absence of Bruton's tyrosine kinase. this results in total absence of B cells and plasma cells in the circulation. this diasese is seen primarily in males. s Secondary infections are seen after 6 months of age when maternal antibodies are depleted (age 9 month in this case), such as: Haemophilus influenzae, Streptococcus pneumoniae (this case), Staphylococcus aureus; Enteroviruses; Giardia lamblia (this case).