Abstract
In Reply.— Dr Rosefsky reports finding 39 cases of immunoglobulin deficiency and five cases of neutropenia among an unstated number of pediatric patients during a 13-year period. Based on this experience, he expresses surprise at the statement that there are few documented cases of transient hypogammaglobulinemia of infancy in the literature. He does not indicate whether the values in his patients were demonstrated on more than one occasion (to rule out laboratory error or postdiarrheal gastrointestinal protein loss) or whether he had later documentation of a normal value. A major factor accounting for the misconception that transient hypogammaglobulinemia of infancy is common is that few (if any) commercial laboratories have their own ageappropriate normal values for infants or children younger than 6 to 7 years of age. Artifactually low immunoglobulin values have been reported frequently in patients in that age range because their values were compared with either adult
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