Abstract
The clinical and immunological data of 8 patients diagnosed with transient hypogammaglobulinemia of infancy (THI) are presented and compared to published data. All patients diagnosed with THI (recurrent sinopulmonary infections, serum immunoglobulins < −2 S.D. for the age, apparently normal cellular immunity, and absence of evidence of other immunodeficiency syndromes) and registered in the Pediatric Rheumatology and Immunology Clinic of Post Graduate Institute of Medical Education and Research, Chandigarh were included in the study. Eight patients were diagnosed with THI. Mean age of onset of symptoms was 5.5 (±2.9) months. All patients had low serum immunoglobulin G (IgG) concentrations at admission. In 3 of the 8 (42.8%) cases, the serum IgA and IgM concentrations were also low. Respiratory infections were the most common presenting complaint. All children received prophylactic cotrimoxazole. The mean follow-up period was 23.6 months (range 10–38 months). Seven of the 8 patients became asymptomatic during follow up, and treatment was stopped at a mean age of 35.3 months. Serum IgG concentrations were normalized in all, except 2 patients, by 15–26 months. Serum IgA persisted to be low in 2 of 8 cases. Two of the 8 patients had severe pneumonia and were given intravenous immunoglobulin (IVIG) during the acute episode. THI is a relatively uncommon disorder and can only be diagnosed with certainty in retrospect. Affected children may have recurrent respiratory infections. IgG levels usually normalize by 2–3 years. Other classes of immunoglobulins may also be affected. Treatment with IVIG is usually not necessary, but may be considered if symptoms are significant. Children with THI need consistent long-term follow- up care.
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