[CIS-PAGID] Asymptomatic hypogammaglobulinemia

[Church, Joseph]

Colleagues:

 

I am seeing a 42yo man with no significant infection history.  A low
globulin fraction on a chem. panel lead to his primary MD to obtain
QUIGs:  IgG 309, IgA <7, IgM 30.  He has protective tetanus and Hib
antibody, but responded to only 3 of 23 serotypes following Pneumovaxtm.

 

Review of past chem. panels suggest these finding have been present for
10 years.  

 

Glaum and Levinson reported similar patients (Ann Allergy Asthma Immunol
2008;100:396-7), but I could not get a sense of what they did about
their findings.

 

Should patients like this be placed on immunoglobulin replacement?

 

Joe Church

Children's Hospital Los Angeles



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