To What Extent do Transient Hypogammaglobulinemia of the Infancy and Allergic Diseases Coexist?

Abstract

Objective: To investigate the clinical features and follow-up results of the patients with transient hypogammaglobulinemia of infancy (THI) and to understand to what extent the condition coexists with allergic diseases. Materials and Methods: Between January 2010 and February 2019, 172 patients who had been referred to Ankara University Faculty of Medicine’s Pediatric Immunology and Allergy Outpatient Department for findings of atopic disease or for frequent infections with a suspicion of PID, who were diagnosed with THI, and followed-up for at least one year were included in this study. Their clinical and immunological features and follow-up results were evaluated retrospectively. Results: Of the 172 patients, 59% were boys. Median time of symptom onset was 14 months (1-46 months), median time of admission was 20 months (6-30 months), and consanguineous marriages were seen in 20% of the families. The most common referral complaints were respiratory tract infections and non-wheezing allergic diseases with rates of 71.5% and 27%, respectively. Cellular immune system analyses were normal. During a median follow-up time of 36 months, 42% of the patients recovered, 25% (n=43) still had THI, 25% (n=43) had unclassified hypogammaglobulinemia (UCG), 4% (n=7) had partial IgA deficiency, and 4% (n=7) had partial IgM deficiency. Allergic diseases were seen in 46% of the patients. An asthma diagnosis was made in 35.4% of the patients, allergic rhinitis in 5% and atopic dermatitis in 12.7%. The skin prick test was positive in 15% of them. Conclusion: THI mostly improves spontaneously in time. However, hypogammaglobulinemia can last until later years in life in a group of patients. Allergic diseases increase with the presence of THI. In patients who are admitted with allergic disease symptoms, underlying hypogammaglobulinemia should also be investigated.