IgG Subclass Deficiency in Children with IgA Deficiency Presenting with Recurrent or Severe Respiratory Infections

Beard, Lorraine J.; Fèrrante, Antonio; Oxelius, Vivi‐Anne; Maxwell, George M.

doi:10.1203/00006450-198610000-00006

Cited by 47 publications

(19 citation statements)

References 13 publications

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“…Only 4 persons (13%) had normal IgG2 levels; 15 (20%) presented IgG2 serum levels less than 0.3 g/l, a level attributed by many authors to the occurrence of severe infections [16,[18][19][20]. Eleven patients (37%) were also IgA-deficient (< 0.05 g/l), an observation also shared by others [2,14]. Total IgG levels varied widely.…”

Section: Discussionmentioning

confidence: 87%

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Undetectable IgG4 in immunoprecipitation: association with repeated infections in children?

Bartmann¹,

Kleihauer²

1988

Eur J Pediatr

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A total of 210 patients with repeated infections were screened for IgG4 deficiency. In 30 patients (14%) IgG4 was undetectable by radial immunodiffusion (less than 30 mg/l). Of these patients 17 (57%) were less than 2 years of age. Concomitant IgA deficiency (IgA less than 0.05 g/l) was demonstrated in 11 cases (37%). IgG2 serum levels below the normal range were found in 26 children. IgG4 could be demonstrated at a concentration of 0.5-29 mg/l in all 30 patients using a more sensitive enzyme-linked immunosorbent assay technique. Although a highly selected group of patients was investigated, the percentage of individuals without detectable IgG4 by immunodiffusion was in the same range as reported in the literature for healthy control persons. It is thus concluded that IgG4 serum reference levels have to be defined using more sensitive methods and that the observed severe infections are more likely to be connected with low serum IgG2 and/or IgA levels than undetectable IgG4 as measured by immunodiffusion.

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Section: Discussionmentioning

confidence: 87%

“…Of our patients, 87% had low or even very low (50%) IgG2 serum levels. A large amount of data has accumulated in the literature [2,14,16,[18][19][20] concerning the coincidence of low serum IgG2 concentrations and severe bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Undetectable IgG4 in immunoprecipitation: association with repeated infections in children?

Bartmann¹,

Kleihauer²

1988

Eur J Pediatr

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“…A similar clinical picture was described in young patients with IgG2 deficiency [4,20,24,25,27,28]. We therefore investigated sera of 76 children with HIV-l-infection for IgG subclass deficiency to evaluate whether IgG2 deficiency might contribute to the high susceptibility to bacterial infection in HIV-infected patients.…”

Section: Introductionmentioning

confidence: 99%

IgG2 deficiency in children with human immunodeficiency virus infection

Bartmann

Grosch-Wörner²,

Wahn

et al. 1991

Eur J Pediatr

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Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Despite elevated serum immunoglobulin levels, a significant deterioration of the antigen specific humoral immune response exists in most cases. We studied the influence of HIV infection on the serum levels of IgG subclasses in children. We investigated 76 children (aged 15 months to 18 years) with HIV-1-infection. Most children (88%) showed elevated serum immunoglobulin levels. IgA (87%) and IgM (74%) were more often above normal levels for age than IgG (60%). IgG subclass serum levels were significantly altered. The increase in total IgG was mainly due to a marked augmentation of the IgG1 fraction. In most cases IgG3 was simultaneously elevated. Ten children (13%) had very low IgG4 levels (less than 0.03 g/l). Out of 61 patients older than 2 years 8 (13%) had a profound IgG2 deficiency with normal or elevated total IgG. Four of them also had low IgG4 levels (less than 0.03 g/l). A correlation between IgG2 deficiency and HIV infection according to the Centres for Disease Control classification for acquired immunodeficiency syndrome could not be demonstrated (three patients with symptomatic and five with asymptomatic infection).

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“…Of some interest is that the IgG subclass deficiency in our patients is found in as sociation with IgA deficiency, an association com mented on in other studies [26][27][28]. Of further interest to this discussion is the observation of a close correla tion between IgG4 and IgE, and their co-regulation by interleukin-4 [29][30][31].…”

Section: Discussionmentioning

confidence: 71%

Immunoglobulin G Subclass Deficiency in Children with High Levels of Immunoglobulin E and Infection Proneness

Loh

Thong

Ferrante

1990

Int Arch Allergy Immunol

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Of 32 unrelated children with serum IgE > 1,000 U/ml, 17 were found to have infection proneness according to standard clinical criteria, and 15 were not infection prone. There were no statistical differences between these 2 groups of children with regard to age, sex, serum IgE levels or prevalence of asthma. However, the prevalence of eczema was significantly lower in the infection-prone group (p = 0.035). Of greater interest was the finding that 7 children in the infection-prone group had IgG subclass and/or IgA deficiency compared with none in the non-infection-prone group (p = 0.006). These results suggest that IgG subclass studies may be warranted in children with markedly elevated levels of serum IgE and proneness to infection.

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IgG Subclass Deficiency in Children with IgA Deficiency Presenting with Recurrent or Severe Respiratory Infections

Cited by 47 publications

References 13 publications

Undetectable IgG4 in immunoprecipitation: association with repeated infections in children?

Undetectable IgG4 in immunoprecipitation: association with repeated infections in children?

IgG2 deficiency in children with human immunodeficiency virus infection

Immunoglobulin G Subclass Deficiency in Children with High Levels of Immunoglobulin E and Infection Proneness

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