The degree of invasiveness of thoracic surgery may influence the extent of immunosuppression in patients undergoing pulmonary lobectomy for pulmonary neoplasm.

A patient presented at the age of 72 years with a life long history of at least 60 years of abdominal crises described by the patient as 'bilious vomiting or migraine'. However, a careful clinical and family history suggested a diagnosis of hereditary angioneurotic oedema and this was confirmed by complement studies. Treatment with oral ethinyltestosterone (Danazol) was successful in abolishing her attacks, initially at a dose of 600 mg. per day and laterally at the low dose of 200 mg per day.

Intravenous immunoglobulin (IVIG) concentrates were originally developed as replacement therapy for individuals with primary deficiencies of the immune system. However, in various well-designed, controlled clinical trials, the ability of IVIG to prevent and possibly treat infections in patients with secondary immune deficiencies has also been considered. In this review, we briefly consider these different applications and suggest whether the data are sufficient to employ IVIG in these clinical settings.

A 66-year-old patient presented with Pneumocystis carinii Pneumonia (PCP) and was found to have hypogammaglobulinaemia, associated with a thymoma that had been resected 17 months earlier. Only one previous case of PCP in association with a thymoma and hypogammaglobulinaemia has been reported, in which the patient died. We report another such patient who was successfully treated with a combination of intravenous immunoglobulin and high dose cotrimoxazole.