“As a Matter of Fact, I Do Not Want This Blood”

Abstract

How many times can one person get pneumonia in a lifetime? This is the question Mr. Enfiktid had after 40 episodes of pneumonia, requiring antibiotics and frequent hospitalizations! Sick and tired of always being on antibiotics, Mr. Enfiktid sought help from our team. At Big University Hospital, Mr. Enfiktid complained of multiple recurring bacterial infections. He spoke to us about his quest to create his own business. Every time he set up a shop, he would be hospitalized for pneumonia, and his businesses would fail. His immune system was certainly compromised! We obtained an IgG level to verify low immunoglobulin levels. High levels are necessary to fight bacterial infections. The concentration of IgG was less than 50% of lower limit of normal. His symptoms and his test results led us to diagnose Mr. Enfiktid with CVID (common variable immunodeficiency disease)—also known as hypogammaglobulinemia—a rare and lifelong disease where B cells do not produce enough antibodies (such as IgAs, IgEs, and IgGs) to fight off infection. He was put on a regimen of intravenous or IV IgG to increase his levels and prevent further infection. While on these doses, Mr. Enfiktid was saved, until we received a hair-raising call from his mother years later (Figs. 11.1 and 11.2).