Hyperimmunoglobulinemia E Syndrome: Radiographic Observations

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Abstract
Susceptibility to recurrent staphylococcal cutaneous and respiratory infections beginning in infancy associated with extreme hyperimmunoglobulinemia E is a recently described primary immunodeficiency syndrome. Other clinical features include depressed cellular immunity and deficient antibody formation. Recurrent pneumonia and cyst formation with variable persistence and expansion characterized the radiographic course in 11 patients. Five cysts resolved with continuous anti-staphylococcal therapy; 2 were resected without recurrence and 4 persisted after surgery and/or antibiotics (2-8 yr). The cysts had dense, necrotic surfaces with fibrous walls, eosinophilic and other inflammatory cell infiltrates and frequent, persistent bronchial connections. Sinusitis (9 of 9) and mastoiditis (3 of 4) were observed radiographically.