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Deficiency of IgG4 in children: association of isolated IgG4 deficiency with recurrent respiratory tract infection.
J Pediatr 1992; 120(1):16-21JPed

Abstract

To study the relationship between serum IgG subclass deficiency and clinical host defense impairment, we reviewed the clinical and immunologic features of 123 patients with a history of recurrent infection who had been examined for immunodeficiency in our laboratory (group 1). We then compared immunoglobulin isotype levels with those in sera from 127 age-matched control subjects without recurrent infection from whom blood had been drawn for evaluation of atopy (group 2). There was a significantly higher prevalence of IgG4 deficiencies among patients with recurrent infections (17% vs 7%; p less than 0.02), solely because of a higher prevalence of isolated IgG4 deficiency (n = 9; 7.3%) than in atopic control subjects (n = 1; 0.8%; p less than 0.05); there was a comparable prevalence of multiple isotype deficiencies that included low levels of IgG4 (9.8% and 6.3%, respectively). All nine group 1 patients with isolated IgG4 deficiency had severe recurrent respiratory tract infections requiring multiple hospitalizations; in addition, five were atopic, five had asthma, and one had chronic diahrrea. Antibody responses to bacterial polysaccharide antigens were normal for age in all patients with isolated IgG4 deficiency; two had defective antibody responses to protein antigens. Isolated IgG4 deficiency appears to be associated with impaired respiratory tract defenses and may occur in the absence of an easily definable antibody deficiency state. This association suggests a physiologic defense role for mucosal IgG4.

Authors+Show Affiliations

Allergy/Pulmonary Division, Lucille Salter Packard Children's Hospital, Standford, Palo Alto, CA 94304.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1731015

Citation

Moss, R B., et al. "Deficiency of IgG4 in Children: Association of Isolated IgG4 Deficiency With Recurrent Respiratory Tract Infection." The Journal of Pediatrics, vol. 120, no. 1, 1992, pp. 16-21.
Moss RB, Carmack MA, Esrig S. Deficiency of IgG4 in children: association of isolated IgG4 deficiency with recurrent respiratory tract infection. J Pediatr. 1992;120(1):16-21.
Moss, R. B., Carmack, M. A., & Esrig, S. (1992). Deficiency of IgG4 in children: association of isolated IgG4 deficiency with recurrent respiratory tract infection. The Journal of Pediatrics, 120(1), pp. 16-21.
Moss RB, Carmack MA, Esrig S. Deficiency of IgG4 in Children: Association of Isolated IgG4 Deficiency With Recurrent Respiratory Tract Infection. J Pediatr. 1992;120(1):16-21. PubMed PMID: 1731015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deficiency of IgG4 in children: association of isolated IgG4 deficiency with recurrent respiratory tract infection. AU - Moss,R B, AU - Carmack,M A, AU - Esrig,S, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 16 EP - 21 JF - The Journal of pediatrics JO - J. Pediatr. VL - 120 IS - 1 N2 - To study the relationship between serum IgG subclass deficiency and clinical host defense impairment, we reviewed the clinical and immunologic features of 123 patients with a history of recurrent infection who had been examined for immunodeficiency in our laboratory (group 1). We then compared immunoglobulin isotype levels with those in sera from 127 age-matched control subjects without recurrent infection from whom blood had been drawn for evaluation of atopy (group 2). There was a significantly higher prevalence of IgG4 deficiencies among patients with recurrent infections (17% vs 7%; p less than 0.02), solely because of a higher prevalence of isolated IgG4 deficiency (n = 9; 7.3%) than in atopic control subjects (n = 1; 0.8%; p less than 0.05); there was a comparable prevalence of multiple isotype deficiencies that included low levels of IgG4 (9.8% and 6.3%, respectively). All nine group 1 patients with isolated IgG4 deficiency had severe recurrent respiratory tract infections requiring multiple hospitalizations; in addition, five were atopic, five had asthma, and one had chronic diahrrea. Antibody responses to bacterial polysaccharide antigens were normal for age in all patients with isolated IgG4 deficiency; two had defective antibody responses to protein antigens. Isolated IgG4 deficiency appears to be associated with impaired respiratory tract defenses and may occur in the absence of an easily definable antibody deficiency state. This association suggests a physiologic defense role for mucosal IgG4. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/1731015/Deficiency_of_IgG4_in_children:_association_of_isolated_IgG4_deficiency_with_recurrent_respiratory_tract_infection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(05)80590-6 DB - PRIME DP - Unbound Medicine ER -