What is the role of chest radiography in the workup of severe combined immunodeficiency (SCID)?

Updated: Apr 28, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Harumi Jyonouchi, MD  more...
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Answer

Chest radiographs in classic SCID show a small or absent thymus. However, infants who are immunologically normal may have no visible thymus if they have an overwhelming infection, such as sepsis or meningitis. Other T-cell defects, especially DiGeorge syndrome, also lack thymic tissue. Presence of thymic tissue does not exclude SCID. Patients with SCID who have mutations in ZAP70 or CD3 typically have normal-sized thymuses.

Chest radiographs are essential for early recognition of pneumonitis caused by viral pathogens and P jiroveci.

Patients with ADA deficiency and cartilage-hair hypoplasia may have bony abnormalities observed in the ribs and vertebrae on chest radiography. In ADA deficiency, chest radiographs show typical cupping and flaring of the costochondral junction.


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