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A 47-year-old woman was admitted to the hospital because of bronchopulmonary disease.
Six years before admission, pneumonia had developed, and asthma and chronic obstructive pulmonary disease had been diagnosed. Thereafter, the patient had pneumonia and sinusitis at least twice a year. Three years before admission, hypogammaglobulinemia was detected. Immune globulin was administered intravenously every 6 weeks, resulting in fewer bouts of pneumonia, until 14 months before admission, when the infusions were no longer approved by her insurer. The patient was able to climb stairs and to take 45-minute walks while taking prednisone (5 mg daily).
Thirty-seven days before admission, the
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