Outcome of hypogammaglobulinemia in children: Immunoglobulin levels as predictors
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- 作者：Ahmet Ozen ; Safa Baris ; Elif Karakoc-Aydiner ; Cevdet Ozdemir ; Nerin Nadir Bahceciler ; Isil Berat Barlan
- 关键词：THI ; CVID ; Unclassified Hypogammaglobulinemia ; Predictors ; Outcome ; Allergy ; B cell ; Antibody response ; Immunoglobulin level ; IgM
- 刊名：Clinical Immunology
- 出版年：2010
- 出版时间：December 2010
- 年：2010
- 卷：137
- 期：3
- 页码：374-383
- 全文大小：1425 K
文摘
We evaluated 131 children (M = 88, F = 43) with hypogammaglobulinemia. Data was analyzed mainly for delineating predictor factors for outcome. The distance from the lower limit of normal (− 2SD) for any single measurement of immunoglobulins (Ig) was calculated and transformed into Ig scores. Mean age and duration of follow-up were 5.06 ± 4.05 and 3.7 ± 3.03 years, respectively. The diagnoses were: 22 CVID, 16 IgA deficiency, 33 transient hypogammaglobulinemia of childhood (THC), 3 selective IgM deficiency and 57 unclassified hypogammaglobulinemia (UCH). Low IgA scores (<−0.124) at presentation were indicative of subsequent development of IgA deficiency or CVID, whereas low IgM score (<−0.038) pointed towards more severe and persistent phenotypes. Combination of low IgM score between 2 and 5 years, impaired antibody response and low B cell counts enabled us to predict persistence of hypogammaglobulinemia beyond 5 years (specificity = 90.5 % and PPV = 94.9 % ) and chronic lung disease (sensitivity = 90.4 % and specificity = 68.3 % ). The set of criteria including low IgM scores, impaired antibody response and low B cell counts provided a high predictive value in detecting those with persistent hypogammaglobulinemia.