[Significance of determining concentrations of subclasses of IgG and IgA--our experience] (original) (raw)
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Immunological investigations in individuals with selective IgA deficiency
Clinical and experimental immunology, 1986
Concentrations of IgG2, IgG4 and IgE were low in 16, 24 and 20% of 25 persons with selective IgA deficiency. Fifty-two per cent had IgD concentrations below 5 iu/ml. Trends for association between any of these parameters and the presence of clinical symptoms were not significant. All patients, except one, had normal amounts of Ig-bearing lymphocytes in the blood. IgG1 antibodies against casein were increased in titre and frequency, whereas IgG4 antibodies were normal. Similar results were found in other sera from persons with selective IgA deficiency.
BMC Immunology
Background: Deficits in disorders of humoral immunity associated with a deficit of antibodies are the most common primary immunodeficiency. Total IgG and IgG subclasses measurements are used to diagnose, differentiate and control in patients with primary and secondary immunodeficiencies. Methods: The purpose of the study was to analyze the structure patients group according to difference between total IgG and sum of the IgG subclasses and to determine factors affecting the level of this difference. This study was based on data collected from 670 children referred to the Department of Clinical Immunology and Pediatrics in order to diagnose the immune disorders. For all children the level of the total of immunoglobulins IgG and of the IgG subclasses (IgG1, IgG2, IgG3, IgG4) were determined. The group of children was divided into subgroups according to gender, age (under 6 years of age, 6.5-12 years, and 12-18 years), and IgG abnormality (below the normal range, normal and above the normal range). In the patients group, the total IgG values were on average higher than sum of the IgG subclasses. Results: Statistical analysis shown the all parameters under study (age, gender and IgG abnormality) influence statistically significant on the discrepancy between the sum of the IgG subclasses and total IgG. Assessment of IgG and IgG subclasses levels is based on different methods what causes the discrepancy between the sum of the IgG subclasses and total IgG. Conclusions: Standardization in that regard is crucial. In addition, we have shown the reliability of the results obtained. Despite the determination in two different laboratories and on different analyzers, as well as the freezing process does not affect the test results.
Development of a Common Variable Immunodeficiency in IgA-Deficient Patients
Clinical Immunology and Immunopathology, 1996
Serum levels of IgG, IgA, and IgM were measured nodeficiency (CVID) are two primary immunodefiby nephelometry and those of IgG subclasses by an ciencies that share clinical features. Occasionally, both diseases have been diagnosed in the same family, ELISA technique using monoclonal antibodies (MoAb). which suggests the existence of some common patho-Peripheral blood lymphocytes were labeled with conjugenic mechanism, but progression from IgA-D to CVID gated MoAb and the percentages of CD3 / , CD4 / , CD8 / , has rarely been documented. We report three cases of and CD20 / cells were counted in a flow cytometer CVID diagnosed 1 to 12 years after IgA-D was detected. (FACScan). ANA and anti-DNA antibodies were mea-Two of these patients presented autoimmune diseases sured with indirect IF and RIA techniques, respecfollowed by a progressive decline in IgG levels. They tively. HLA class I and II antigens were determined by are currently on intravenous immunoglobulin therapy serological and molecular techniques, respectively.
Asian Pacific Journal of Allergy and Immunology Launched By the Allergy and Immunology Society of Thailand, 2009
IgG subclass deficiencies are common immune system disorders during childhood. The aim of this retrospective study was to review clinical findings and laboratory results of patients with IgG subclass deficiencies in order to determine the changes in serum IgG subclass levels during follow-up, the percentage and time span until normalization of the IgG subclass levels to age-corresponding normal levels, the type of infections incurred and the benefits of prophylaxis. Among the 59 pediatric patients reviewed, the most frequent defect was an IgG3 subclass deficiency (77%). Nine percent of the patients had an isolated IgG2 deficiency and 14% had an IgG2+G3 deficiency. The most common clinical presentations were recurrent upper respiratory tract infections, followed by pneumonia, acute gastroenteritis and urinary tract infections. Atopy was present in 15% of the patients. Ninety percent of the patients were given a prophylactic treatment (benzathine penicillin, oral antibiotics, oral bacterial lysate or intravenous immunoglobulin). The frequency of recurrent infections decreased from 13.4 +/- 7.4 per year to 5.7 +/- 3.9 in patients receiving a prophylactic regimen. Serum IgG subclass levels reached normal ranges in 30% of the patients in the IgG3 deficiency group and in 35.7% of the patients in the IgG2+G3 deficiency group. Patients with an isolated IgG2 deficiency did not reach age-related normal levels during the study period. Our study shows that IgG subclass levels may normalize in 30 to 40% of patients at about 6 years of age. We emphasize the need of monitoring IgG levels together with the clinical symptomatology in affected individuals and initiate preventive measures when appropriate.
Association of anti-IgA antibodies with adverse reactions to γ-globulin infusion
The Journal of Allergy and Clinical Immunology, 2011
Serum IgG anti-IgA antibody has been associated with the development of adverse reactions, (including non-IgE mediated anaphylaxis) to intravenous immunoglobulin (IVIG) in patients with undetectable IgA (here defined as <7 mg/dL). 1 Class-specific anti-IgA antibodies bind both IgA1 and IgA2; they are found in 25-30% of IgA-deficient individuals, but not in those with IgA> 7mg/dL. 2 Subclass-specific (or limited specificity) anti-IgA reacts with only one subclass [IgA1, IgA2m(1) or IgA2m(2)]. 2 It is estimated that up to 40% of patients with selective IgA deficiency and 9-25% of patients with common variable immunodeficiency (CVID) may have IgG anti-IgA. 3 IgE anti-IgA has been found much less frequently. Three of four patients with IgE anti-IgA had anaphylaxis to gammaglobulin or other blood products. 45 We conducted a retrospective and prospective observational study to evaluate the possible association with adverse reactions of IgG and/or IgE anti-IgA in IgA-deficient patients receiving IVIG or subcutaneous immunoglobulin (SCIG) at Children's Hospital Boston, Boston, MA, and Brigham and Women's Hospital, Boston, MA. All investigations were conducted according to the policies and procedures of the Institutional Review Boards of both institutions. Among 425 immunodeficient patients receiving IgG therapy, we identified 35 (8.2%) with undetectable IgA; 22 were enrolled. Twenty of these were studied retrospectively (medical record review for one year prior to enrollment) and prospectively (6 months) for symptoms
IgA Deficiency: Correlation Between Clinical and Immunological Phenotypes
Journal of Clinical Immunology, 2009
Background IgA deficiency (IGAD) is the most common primary antibody deficiency. Although many affected individuals have no apparent symptom, selected patients suffer from recurrent mucosal infections, allergies, and autoimmune diseases. We aimed to investigate the clinical features in relation to immune function of Iranian patients with symptomatic IGAD. Methods Thirty-seven patients (21 male and 16 female), aged 4–32 years, were evaluated in this study. Patients were followed for a total of 131 patient years with a mean follow-up of 3.5 years per patient. Results The most prevalent presentations were recurrent infections occurring in 27 subjects, followed by allergy in eight cases and autoimmunity in two patients. However, during the follow-up period, 35 patients developed infections in respiratory and gastrointestinal tracts, necessitating medical care. Apart from infections, allergy was the most frequent complaint (31 cases); the major features were asthma, atopic dermatitis, and allergic rhinoconjunctivitis. Autoimmune diseases were documented in ten cases; thyroiditis was the most common. In 31 patients who received unconjugated pneumococcal polyvalent vaccine, antibody response against polysaccharide antigen was measured before and 28 days after vaccination. One fourth of vaccinated patients were hyporesponsive to vaccine; four of these patients developed bronchiectasis. The patients with IGAD were classified into two groups: group 1 (14 cases) consisted of patients with IGAD and other associated immune defects, such as immunoglobulin G (IgG) subclass deficiency and defective specific antibody production. Group 2 (23 cases) had isolated IGAD without other immunological abnormalities. There was a significantly increased number of lower respiratory tract infections in group 1 compared with group 2 (P = 0.006). Moreover, four patients of group 1 had bronchiectasis whereas none of the patients in group 2 developed this complication (P = 0.015). Conclusion Subclassification of IGAD regarding the existence of associated immune defects is useful in terms of morbidity and planning for medical care. IgA-deficient patients with concomitant immune defects such as defects in specific antibody production have higher rates of recurrent infections and bronchiectasis, which necessitates more effective monitoring.
Demonstration of IgG subclass (IgG1 and IgG3) in patients with positive direct antiglobulin tests
Immunohematology, 2019
Serologic characterization of autoantibodies helps in the management and monitoring of the course of autoimmune hemolytic anemia (AIHA). The purpose of this study was to evaluate gel centrifugation test (GCT) cards for immunoglobulin G (IgG) titer and determination of IgG subclasses IgG1 and IgG3 and their influence on hemolysis. Eighty direct antiglobulin test (DAT)-positive patients were examined with the help of GCT cards for IgG titer and IgG subclasses. The results were correlated with the presence and absence of hemolysis. A statistically significant (p < 0.005) association of hemolysis with increasing anti-IgG titer was observed. When IgG titer was 30 or less, 28 (50.91%) patients had no hemolysis, whereas 15 (93.75%) patients had features of hemolysis when titer was at least 300. Statistically significant (p < 0.005) association of subclass of IgG (IgG1, IgG3) coating the red blood cells with intravascular hemolysis was also seen. Twenty-nine (80.56%) patients had evid...
LIMITS AND POSSIBILITIES IN A PRIMARY SELECTIVE IgA DEFICIENCY TREATMENT – CASE PRESENTATION
Romanian Journal of Pediatrics, 2017
The primary deficit of IgA is the most common congenital immunodeficiency defined by the values of serum IgA below 0.07 g/l and normal values of IgG and IgM. Most cases are asymptomatic, only 10-15% is manifested by recurrent or persistent sinopulmonary infections, autoimmune diseases, allergies, malignancies. Some cases develop over the time a common variable immunodeficiency. The frequency of anti-IgA antibody justifies the cautiously use of transfusions of blood, plasma or intravenous immunoglobulin. The authors present a case of primary selective IgA deficiency, where the severity of infectious exacerbations appears to be due to the combination of a lack of IgG4, and discuss the possibilities and limits of therapy in light of recent data from the literature.