Transient recovery of serum IgG level by transfer factor in a case of dysgammaglobulinemia

Abstract

Dysgammaglobulinemia type 1 is one of congenital immunodeficiency syndromes which is characterized by higher or normal serum IgM level and deficiency of IgG and IgA.Recently we encountered a one-year-old boy who had recurrent respiratory infections and lymphadenitis; IgG and IgA levels in his serum were extremely low in spite of the upper limit of normal range of serum IgM level. Salivary IgA was also deficient. The percentage of EAC-rosette forming cells and surface IgA bearing lymphocytes was lowered. Delayed hypersensitivity skin tests with PHA, PPD and candida antigens were normal. lymphocyte stimulations induced by the mitogens, PHA and pokeweed were also normal.Treatment of this patient was started with intravenous administration of sulfonated γ-globulin. With this therapy serum IgM level was gradually decreased. γ-globulin replacement therapy was repeated every three or four weeks. As the patient was suffered from interstitial pneumonitis, transfer factor (1 unit/week, 4 units) therapy was also started. During transfer factor therapy the serum IgG levels of this patient was kept at the normal range for three months without γ-globulin replacement therapy.Although the mechanism of transient recovery of serum IgG level by transfer factor is not clear, we suspect that the switch from IgM to IgG synthesis may have been accomplished by a nonspecific facilitation by transfer factor of T-B cell interaction in our patient.