Five years of experience in transient hypogammaglobulinemia of infancy

INTRODUCTION

Transient hypogammaglobulinemia of infancy (THI) is a clinical entity, characterized by delay in immunoglobulin synthesis. In this study, cases which were followed with hypogammaglobulinemia pre-diagnosis and received THI diagnosis were retrospectively evaluated.

METHODS

193 patients, who were verified THI diagnosis in Dr. Behçet Uz Children’s Hospital, Department of Immunology between January 2011 and December 2015, were included in the study. Clinical, laboratory and demographic data of the patients were retrospectively analyzed.

RESULTS

In the study, 70.5% of 193 cases were male. The age of symptoms was 11.7±7.0 month, the age of hypogammaglobulinemia recovery was 30.6±10.5 month. The cases were most frequently admitted (40.9%) for the recurrent upper respiratory tract infection. Only one case had immunodeficiency in the family history. At the admission, the immunoglobulin levels were as follows; IgG: 420.2±110.6 mg/dL, IgA: 29.8±23.3mg/dL, IgM: 71±3.1mg/dL. In vaccine responses; anti tetanus 75.9% (60/79), anti HBs 91.6% (141/154) and anti hemophilus influenza type B was 86.4% (51/59) positive. Twenty five (13%) of the patients received only antibiotic prophylaxis, 19 of them (9.8%) received only IV gamma globulin replacement, and 6 of them ( 3.1%) received both. There was no statistically significant difference between age of recovery and infection frequency, clinical presentation, vaccination response, IV gamma globulin replacement and antibiotic prophylaxis (p<0.05).

DISCUSSION AND CONCLUSION

THI is usually recovers spontaneously around 3 years of age. There is no relationship between age of recovery and clinical presentation, vaccine responses, IV gamma globulin replacement and antibiotic prophylaxis. The cases must be monitored regularly for correct diagnosis.