Richard Brennan began penicillamine therapy after he was diagnosed with Wilson’s disease (manifested by copper accumulation in the tissues) at age 10 years. Ten months after beginning this treatment he began to experience multiple sinus infections, and one episode of pneumonia. Recently he came to the emergency room with acute diarrhea, vomiting, fever, and foul-smelling intestinal gas. Stool samples revealed the presence of trophozoites of Giardia. Blood tests showed normal levels of B and T cells and normal IgM and IgG concentrations, but markedly decreased IgA at 6 mg/dl (normal range 40–400 mg/dl). Richard was treated for his giardiasis with metronidazole. His selective IgA deficiency was associated with penicillamine, shown previously to be a complication in some patients with Wilson’s disease. His IgA levels returned to normal when penicillamine was discontinued. This is an example of a drug-in duced transient form of IgA deficiency. Which of the following antibodies that uses the same transport receptor as dimeric IgA would have been present in the lumen of the gastrointestinal tract and mucosal secretions of Richard while he was taking penicillamine? a. IgD b. IgM c. IgG d. IgE e. none of the above.
Richard Brennan began penicillamine therapy after he was diagnosed with Wilson’s disease (manifested by copper accumulation in the tissues) at age 10 years. Ten months after beginning this treatment he began to experience multiple sinus infections, and one episode of pneumonia. Recently he came to the emergency room with acute diarrhea, vomiting, fever, and foul-smelling intestinal gas. Stool samples revealed the presence of trophozoites of Giardia. Blood tests showed normal levels of B and T cells and normal IgM and IgG concentrations, but markedly decreased IgA at 6 mg/dl (normal range 40–400 mg/dl). Richard was treated for his giardiasis with metronidazole. His selective IgA deficiency was associated with penicillamine, shown previously to be a complication in some patients with Wilson’s disease. His IgA levels returned to normal when penicillamine was discontinued. This is an example of a drug-in duced transient form of IgA deficiency. Which of the following antibodies that uses the same transport receptor as dimeric IgA would have been present in the lumen of the gastrointestinal tract and mucosal secretions of Richard while he was taking penicillamine? a. IgD b. IgM c. IgG d. IgE e. none of the above.
Chapter10: Reconstitution Of Powdered Drugs
Section: Chapter Questions
Problem 4.7P
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| Richard Brennan began penicillamine therapy after he was diagnosed with Wilson’s disease (manifested by copper accumulation in the tissues) at age 10 years. Ten months after beginning this treatment he began to experience multiple sinus infections, and one episode of pneumonia. Recently he came to the emergency room with acute diarrhea, vomiting, fever, and foul-smelling intestinal gas. Stool samples revealed the presence of trophozoites of Giardia. Blood tests showed normal levels of B and T cells and normal IgM and IgG concentrations, but markedly decreased IgA at 6 mg/dl (normal range 40–400 mg/dl). Richard was treated for his giardiasis with metronidazole. His selective IgA deficiency was associated with penicillamine, shown previously to be a complication in some patients with Wilson’s disease. His IgA levels returned to normal when penicillamine was discontinued. This is an example of a drug-in duced transient form of IgA deficiency. Which of the following antibodies that uses the same transport receptor as dimeric IgA would have been present in the lumen of the gastrointestinal tract and mucosal secretions of Richard while he was taking penicillamine? |
| a. IgD |
| b. IgM |
| c. IgG |
| d. IgE |
| e. none of the above. |
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