Phenotypic parameters predict time to normalization in infants with hypogammaglobulinemia.

Autor: Van Winkle RC; Thomas Jefferson University, Philadelphia, PA, USA., Hauck WW, McGeady SJ
Jazyk: angličtina
Zdroj: Journal of clinical immunology [J Clin Immunol] 2013 Nov; Vol. 33 (8), pp. 1336-40. Date of Electronic Publication: 2013 Sep 08.
DOI: 10.1007/s10875-013-9937-7
Abstrakt: Purpose: Infants with recurrent infection may be found to have hypogammaglobulinemia without impaired specific antibody responses. Many will be diagnosed with transient hypogammaglobulinemia of infancy.
Methods: This study used a parametric survival analysis of 100 infants with hypogammaglobulinemia to predict time to normalization.
Results: Aggregate initial immunoglobulins (IgG + IgA + IgM), as a percentage of age-adjusted normal, predicted time to resolution: median time to resolution for the infants in the lowest quartile of aggregate levels (≤81 % of age-adjusted lower limits) was greater than 5 years, with 34 % resolving in 3 years. For infants in the highest quartile (≥130 % of age-adjusted lower limits), the median was 9.9 months, with 77 % resolving in 3 years (P = 0.008). Initial IgG level, as a percentage of age-adjusted normal, also predicted resolution: the median time in the lowest quartile (≤78 % of age-adjusted lower limits) was greater than 5 years, with 36 % resolving in 3 years. In the highest quartile (≥128 %), the median time was 14.5 months, with 70 % resolving in 3 years (P = 0.010). Male sex was associated with more rapid resolution. The median time in males was 13 months, with 73 % resolution in 3 years. The median time in females was greater than 5 years, with 32 % resolution in 3 years.
Conclusions: These results suggest that if a term infant presents with hypogammaglobulinemia, protective specific antibody titers, and an absence of other known immune deficiency, initial immunoglobulin levels and sex may predict time to normalization.
Databáze: MEDLINE
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