Low and high serum IgG associates with respiratory infections in a young and working age population.

Abstract

We investigated health consequences and genetic properties associated with serum IgG concentration in a young and working age general population. Northern Finland Birth Cohort 1966 (NFBC1966, n=12,231) health data have been collected from birth to 52 years of age. Relationships between life-long health events, medications, chronic conditions, lifestyle, and serum IgG concentration measured at age 46 years (n=5430) were analysed. Regulatory mechanisms of serum IgG concentration were considered. Smoking and genetic variation (FCGR2B and TNFRSF13B) were the most important determinants of serum IgG concentration. Laboratory findings suggestive of common variable immunodeficiency (CVID) were 10-fold higher compared to previous reports (73.7 per 100,000 vs 0.6-6.9 per 100,000). Low IgG was associated with antibiotic use (relative risk 1.285, 95% CI 1.001-1.648; p=0.049) and sinus surgery (relative risk 2.257, 95% CI 1.163-4.379; p=0.016). High serum IgG was associated with at least one pneumonia episode (relative risk 1.737, 95% CI 1.032-2.922; p=0.038) and with total number of pneumonia episodes (relative risk 2.167, 95% CI 1.443-3.254; p<0.001). CVID-like laboratory findings are surprisingly common in our unselected study population. Any deviation of serum IgG from normal values can be harmful; both low and high serum IgG may indicate immunological insufficiency. Critical evaluation of clinical presentation must accompany immunological laboratory parameters. Oulu University Hospital VTR, CSL Behring, Foundation for Pediatric Research.