Conditions for which IVIG not indicated

Question:

9/12/2017
I recently saw a 55 year-old woman for the first time with a history of frequent infections over the last year. She has been on Abx 7 times in treating sinus infections and once for ear infection. She has had steroid shots twice. She is normally treated with normal course of 10 days and it does seem to be helpful. She feels better for a couple of weeks and then symptoms return with rhinitis, feeling bad and congestion. No history of pneumonia in the past year. She is normally sick 4-5 times a year but this year was worse. She had blood testing by another physician recently with IgG 360 mg/dl, IgA 75 mg/dl, IgM 10 mg/dl. Tetanus titer was protective and pneumococcal was protective to 16/23. She had CT sinus 8/14 that was clear. She is leaning toward wanting to start replacement immunoglobulin. I told her that she doesn't have the diagnosis of CVID and could go either way with watchful waiting or replacement. What is your opinion?