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The diaphragm separates the chest from the abdomen. The esophagus (swallowing tube) passes through the hiatal opening in the diaphragm to reach the stomach. With a hiatal hernia, part of the stomach is displaced upwards into the chest (Figure 1). Large hiatal hernias may cause chronic gastrointestinal blood loss leading to iron deficiency anemia.
It is possible to have either a global IgG deficiency, or a deficiency of one or more specific subclasses of IgG. [1] [2] The main clinically relevant form of IgG deficiency is IgG 2. IgG 3 deficiency is not usually encountered without other concomitant immunoglobulin deficiencies, and IgG 4 deficiency is very common but usually asymptomatic. [3]
A hiatal hernia or hiatus hernia [2] is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. [1] [3] This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn.
IgG deficiency - IgG deficiency is a lack of IgG in the absence of other immunoglobulin deficiencies. IgG levels of 300–600 mg/dL show a mild to moderate reduction of IgG while levels below 200 mg/dl are classified as a severe deficiency. [6] Those with IgG deficiency often get chronic or reoccurring pyogenic respiratory tract infections. [7]
Endoscopic findings may include a hiatal hernia, esophagitis, strictures, tumors, or masses. [2] Increased pressure at the LES over time may result in an epiphrenic diverticulum. [ 2 ] Further evaluation for mechanical causes of obstruction may include CT scans, MRI, or endoscopic ultrasound.
This treatment replenishes Ig subtypes that the person lacks, is given at frequent intervals for life, and is thought to help reduce bacterial infections and boost immune function. [25] Before therapy begins, plasma donations are tested for known blood-borne pathogens, then pooled and processed to obtain concentrated IgG samples.
Humoral immune deficiency (including B cell deficiency or dysfunction), with signs or symptoms depending on the cause, but generally include signs of hypogammaglobulinemia (decrease of one or more types of antibodies) with presentations including repeated mild respiratory infections, and/or agammaglobulinemia (lack of all or most antibody production) which results in frequent severe infections ...
Humoral immune deficiencies are conditions which cause impairment of humoral immunity, which can lead to immunodeficiency.It can be mediated by insufficient number or function of B cells, the plasma cells they differentiate into, or the antibody secreted by the plasma cells. [7]
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