Ian Thorpe Drops Out AND Expands the Differential

In a sudden and unexpected move Ian Thorpe, by far Australia’s best swimmer, has dropped out of the Commonwealth games. During training Ian, who was said to be quickly improving, was unable to complete his usual regiment, becoming winded after twelve laps. Afterwards, on national television, he announced his withdrawal from the Commonwealth games.

Previously I stated that after reading the reports issued by the press I believed that Ian Thorpe may have HIV. This was due to the following factors:

1. Ian has now been ill for more than three weeks with a “viral” syndrome and I do not believe that this is likely.

2. His coach, Alan Thompson, stated that: “The antibodies in his blood were beginning to rise”. I believe that he was referring to Ian having a certain type of immunodeficiency and by far the most likely diagnosis in his age group is HIV.

3. The Doctors and Ian himself are being extremely vague concerning what is going on and the result of his testing.

4. Ian has been placed on antibiotics for a viral condition and this is not commonly done unless the doctors are suspecting something deeper.

During his press conference Thorpe revealed that during his childhood he had to take a three month vacation from school for another bout of “viral bronchitis”. This is interesting because it hints to another diagnosis that is less likely, although possible.

Immune deficiencies are a group of disorders characterized by the dysfunction of the immune system. There are a number of disorders but each expresses itself differently depending on the specific disorder present. Although a lengthy discussion of the topic would surely not be appropriate here, you can find more specific information elsewhere.

Generally, immune deficiency would manifest as recurrent infections. However, due to Ian current age and his known health status I think that we can rule out the more malignant ones. In addition if you remember Alan Thompson, the coach for the Australian Olympic team, stated:

“He got some blood tests back today and they were positive and showed an improvement in the blood parameters and the anti-bodies are doing well"

In my earlier post I speculated that Mr. Thompson may have been misinformed and that more likely he was referring to the White blood Cell (WBC) count that is often checked on a cell count. But what if he wasn’t misinformed? What if Mr. Thompson knew exactly what he was saying?

Are there any immune deficiencies that would express themselves as a decrease in the amount of antibodies in the blood and would not present with consistent recurrent infections. I placed consistent in bold type because if Ian Thorpe was consistently ill he would not have been able to achieve all he has until now and so I believe we can assume he is healthy most of the time.

One diagnosis jumps to mind more than any other: Selective IgA Deficiency

This deficiency may be congenital or acquired (meaning people get it later in life). More importantly, it’s not altogether uncommon and many of those who have the disorder lead normal healthy lives. In addition, it is not uncommon for it to manifest as recurrent upper respiratory infections. the same condition Ian has ahd for three week now.

Ok, I admit, my bet is still on HIV. But a good differential always includes a number 2. All that’s left now is to wait for someone to leak some more information.