1.5岁，男孩，反复患皮肤化脓感染、上呼吸道感染及肺炎等，PPD(-)。血常规：白细胞9.6x109/L，N0.60,L0.40,血清免疫球蛋白总量低于200mg/dl。为进一步确诊，以下哪项最关键

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