Diagnosis of x linked agammaglobulinamia should be suspected if

Ref Robbins 9/e p240-241 Classically, this disease is characterized by the following: * Absent or markedly decreased numbers of B cells in the circulation, with depressed serum levels of all classes of immunoglobulins. The numbers of pre-B cells in the bone marrow may be normal or reduced. * Underdeveloped or rudimentary germinal centers in peripheral lymphoid tissues, including lymph nodes, Peyer patches, the appendix, and tonsils * Absence of plasma cells throughout the body * Normal T cell-mediated responses