An adult patient with hyperimmunoglobulemia E (Job's) syndrome, end-stage renal disease and repeated episodes of peritonitis.
We report the first case of an adult patient with hyperimmunoglobulemia E (Job's) syndrome, end-stage renal disease and repeated episodes of Staphylococcus peritonitis. A 42-year-old black female with end-stage renal disease was treated with hemodialysis, and later switched to peritoneal dialysis because of severe vascular access problems. On CAPD, she had numerous (> 15) episodes of staphylococcal peritonitis. Past history included chronic atopic eczema and repeated sinopulmonary infections since childhood. She was found to have serum IgE levels greater than 10,000 units/ml. This combination of repeated infections, chronic skin condition and phenomenal elevation of IgE levels establish the diagnosis of hyperimmunoglobulemia E (Job's) syndrome. The cause of repeated episodes of Staphylococcal peritonitis are presumed to be related to impaired host defense mechanisms known to be present in patients with this disorder. As nephrologists, we should be aware that patients with impaired host defense mechanisms are highly susceptible to peritonitis in the presence of an indwelling peritoneal catheter.
Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467.
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D000328:Adult; D005260:Female; D006801:Humans; D007589:Job Syndrome / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology*; D012008:Recurrence; D013203:Staphylococcal Infections / Q000209:etiology*