An unlucky WHIMsical child – A case report

Abstract

Immunodeficiency in children often has the worst prognosis and there are varied primary and secondary causes for immunodeficiency. Warts Hypogammaglobulinemia, Infections, and Myelokathexis (WHIM) syndrome is a congenital immune deficiency that increases the likelihood of human papillomavirus infection (Warts), a low white blood cell count, hypogammaglobulinemia, and bone marrow myelokathexis. We present the case of a 3-year-old child brought by an orphanage caretaker with a history of recurrent swelling in both eyelids, multiple skin lesions all over the body, and recurrent respiratory tract infections. The child has been treated with native medications elsewhere with no improvement noted. Work up done for immune deficient states and bone marrow evaluation revealed myelokathexis with neutropenia/lymphopenia which made the possibility of WHIM syndrome. Treatment with colony stimulating factor has been initiated but could not be continued due to financial constraints. This report emphasis on the need for work-up to make early diagnosis and intervention of the disease as such than treating only their manifestations.