[Frequent airway infections]

A 44-year-old patient experienced increasing shortness of breath and cough with yellow expectoration. Physical findings of the patient were not remarkable, whereas x-ray chest examination revealed cicatricial changes of the lower fields of the right lung. Laboratory findings showed a significant reduction of plasma gamma-globulin levels due to a global deficiency of all immunoglobulins. An infectious origin of the immunoglobulin deficiency was not detected. After exclusion of other acquired etiologic conditions, the diagnosis of a variable immunodeficiency syndrome was established. After antibiotic treatment with gyrase-inhibitors, an immunoglobulin-substitution program was initiated. Immediately after the start of an immunoglobulin infusion, the patient developed an allergic reaction. Pretreatment with antihistamine drugs eliminated allergic symptoms. Following immunoglobulin treatment, incidence and severity of infectious diseases were significantly reduced.