Serum Immunoglobulin Levels In Patients Research Articles

Long-term Effect of Ofatumumab on Serum Immunoglobulin Levels in Patients with Relapsing Multiple Sclerosis (P9-6.007)

Long-term Effect of Ofatumumab on Serum Immunoglobulin Levels in Patients with Relapsing Multiple Sclerosis (P9-6.007)

Association of Serum Immunoglobulin Levels with Solid Cancer: A Systematic Review and Meta-analysis.

The nature of humoral immunity in carcinogenesis remains poorly understood. In this systematic review and meta-analysis, we aimed to evaluate the association of serum immunoglobulin classes with solid cancer and test our hypothesis that the immune escape of tumors is accompanied by dysregulated systemic immunoglobulin class-switching. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched the Cochrane Library, Embase, and MEDLINE/PubMed databases for observational studies investigating the association between serum immunoglobulins (IgA, IgG, and IgM) and histologically confirmed diagnosis of solid cancer in adults. We selected case-control studies, including more than 20 cases, and those explicitly stating that no form of anticancer treatment was administered prior to immunoglobulin measurement. No eligible cohort studies were identified. The primary summary measure was the standardized mean difference (SMD) with 95% confidence intervals (CI) calculated using a random effects model. Pooling 11 eligible studies comparing serum IgA levels in 1,351 patients and 560 control subjects revealed a statistically significant SMD (1.50; 95% CI, 0.96-2.04). Nonsignificant SMDs were observed for the 14 selected studies investigating serum IgG [SMD, -0.02 (95% CI, -0.22 to 0.18)] and for the 10 studies reporting serum IgM [SMD, 0.11 (95% CI, -0.10 to 0.32)]. Substantial heterogeneity between studies was observed despite sensitivity analysis by immunoglobulin measurement method, control matching, type of cancer, stage of disease, and sequential study exclusion. Serum immunoglobulin levels in patients diagnosed with solid cancer might be skewed toward class-switching to IgA, possibly reflecting Th2-polarized immunity. Further combinatorial analyses of serum immunoglobulin isotypes alongside other immune parameters in databases and observational studies are warranted.

Serum immunoglobulin levels in patients with lymphoproliferative diseases in Erbil, Kurdistan region, Iraq

Background and objectives: Lymphoproliferative neoplasms are among the commonest human neoplasia. Immune dysregulation is frequently associated with many of these diseases, particularly those related to B-cell origin. This study aimed to find out the immunological status of newly diagnosed patients with lymphoproliferative disorders. Methods: This study was carried out in Erbil province during the period from November 2010 to April 2011. Fifty two newly diagnosed patients (34 males and 18 females) with lymphoproliferative disorders referred to Nnakaly Hospital for blood disease and 20 healthy control subjects had been included in this study. Determination of immunoglobulin subclasses by radial immunodiffusion in addition serum protein electrophoresis has been performed for each sample for the detection of monoclonal bands. Results: Serum IgM and IgA level were decreased in all groups of patients with different lymphoproliferative disorders compared to control group. Serum IgG level showed insignificant reduction in acute lymphocytic leukemia and chronic lymphocytic leukemia patients, but it was increased in non Hodgkin lymphoma, Hodgkin lymphoma and multiple myeloma patients. Paraproteinemia had been seen in all patients with multiple myeloma while only 10% of chronic lymphocytic leukemia and non Hodgkin lymphoma showed paraproteinemia. No M-band had been noticed in acute lymphocytic leukemia and Hodgkin lymphoma. Conclusion: There were some conflicting data regarding serum immunoglobulin levels in newly diagnosed patients with lymphoproliferative disorders in Erbil, Iraq.

Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long‐Term Effects on Serum Immunoglobulins

ObjectiveB cell–depletion therapy based on rituximab is a therapeutic option for refractory disease in patients with systemic lupus erythematosus (SLE). The aim of this observational study was to document long‐term effects on B cell function by following serum immunoglobulin levels in patients with SLE treated with rituximab in routine clinical practice.MethodsWe included 57 consecutive patients with SLE treated with rituximab and concomitant/sequential immunosuppressants and measured serum total IgG, IgM, and IgA and IgG anti‐dsDNA antibodies, over a median of 48 months most recent followup. Flow cytometry was used prospectively to assess B cell phenotypes in 17 of 57 patients.ResultsTwelve patients (21%) had persistent IgM hypogammaglobulinemia (<0.4 gm/liter), and 4 of 57 (5%) had low IgG (<7 gm/liter) at the most recent followup (range 12–144 months). This was not associated with serious adverse events or high anti–double‐stranded DNA (anti‐dsDNA) antibodies (>1,000 IU/ml; normal <50 IU/ml). Factors predictive of low serum IgM included baseline serum IgM ≤0.8 gm/liter (receiver operator curve analysis) and subsequent therapy with mycophenolate mofetil (MMF; odds ratio 6.8, compared with other immunosuppressants). In patients maintaining normal IgM levels (9 of 17), the frequency of circulating IgD+CD27+ B cells was significantly higher (P = 0.05). At 12 months after rituximab, 7 of 30 SLE patients with baseline anti‐dsDNA ≤1,000 IU/ml had lost seropositivity.ConclusionLower baseline serum IgM levels and sequential therapy with MMF were predictive of IgM hypogammaglobulinemia after rituximab in SLE, but this was not associated with higher levels of anti‐dsDNA antibodies or an increased risk of infections. This provides useful directions for clinicians regarding rituximab and sequential immunosuppressive treatment for patients with SLE.

Distinct effects of methotrexate and etanercept on the B cell compartment in patients with juvenile idiopathic arthritis.

ObjectiveB cells have been shown to play an important role in the pathogenesis of rheumatoid arthritis and juvenile idiopathic arthritis (JIA). Current treatments include the disease-modifying antirheumatic drugs methotrexate (MTX) and tumor necrosis factor α inhibition with etanercept. This study was undertaken to determine how these drugs influence the B cell compartment in patients with JIA.MethodsB cell subpopulations and follicular helper T (Tfh) cells in the peripheral blood of JIA patients were investigated by multicolor flow cytometry. Serum immunoglobulin and BAFF levels were determined by enzyme-linked immunosorbent assay.ResultsThere was a significant decrease in transitional B cells and significantly lower serum immunoglobulin levels in patients receiving MTX than in untreated patients and those receiving etanercept. In contrast, etanercept treatment had no effect on most of the B cell subpopulations, but resulted in significantly lower BAFF levels and increased numbers of Tfh cells. Thus, our findings indicate an unexpected and previously unknown direct effect of low-dose MTX on B cells, whereas etanercept had a more indirect influence.ConclusionOur results contribute to a better understanding of the potency of MTX in autoantibody-mediated autoimmune disease and present a possible mechanism of prevention of the development of drug-induced antibodies to biologic agents. The finding that MTX and etanercept affect the B cell compartment differently supports the notion that combination therapy with etanercept and MTX is more effective than monotherapy.

Serum immunoglobulin levels predict fibrosis in patients with non-alcoholic fatty liver disease

A third of the population are estimated to have NAFLD of varying severity. Serum immunoglobulins are frequently elevated in patients with chronic liver disease, but little is known about serum immunoglobulin levels in patients with NAFLD. Aim of this study was to evaluate serum immunoglobulin levels (IgA, IgG, and IgM) in a large cohort of patients with biopsy-proven NAFLD and determine if immunoglobulin levels are associated with clinical or histological features. Patients seen in a tertiary fatty liver clinic between 1999 and 2009 were included. Liver biopsies were assessed using the Kleiner score. Immunoglobulin levels and other blood tests were taken at time of biopsy. 285 patients (110 simple steatosis and 175 NASH) had serum immunoglobulins measured within 6months of liver biopsy. 130 (46%) patients had elevated (>1× upper limit of normal) serum IgA levels, 28 (10%) patients had elevated IgG and 22 (8%) raised IgM. Serum IgA levels were elevated more frequently in patients with NASH compared with subjects with simple steatosis (55% vs. 31%, p<0.001). Overall, 55 (19%) patients had advanced liver fibrosis (Kleiner stage 3-4). There was a significant positive association between serum IgA levels and the stage of fibrosis (p<0.001). Serum IgA, age, platelets, AST/ALT ratio and BMI were all independently with advanced fibrosis following multivariate analysis. A model constructed from these independent predictors accurately predicted advanced fibrosis (AUROC 0.87). The serum IgA level was frequently elevated in patients with NAFLD and was an independent predictor of advanced fibrosis.

Total serum immunoglobulin levels in patients with RA after multiple B-cell depletion cycles based on rituximab: relationship with B-cell kinetics

To investigate whether the incidence of secondary hypogammaglobulinaemia in patients with RA following rituximab was related to patterns of B-cell return and relapse. CD19(+) B-cell and serum immunoglobulin (sIg) determinations were done every 2 or 3 months in 137 consecutive patients treated with one or more courses of rituximab-based B-cell depletion therapy. The pattern of B-cell return, either concordant or discordant with relapse, was also recorded. There were 119 responders. Before treatment, three patients had low IgM and four had low IgG. After the first cycle, low IgM or IgG was present in 9.2% (11/119) and 11.8% (14/119) of the patients, respectively, increasing to 38.8% (8/18) and 22.2% (4/18) after five cycles. The mean percent maximum sIg decrease/cycle was relatively constant. The CD19(+) B-cell count at repopulation was not correlated with immunoglobulin (Ig) levels after each cycle. Patients discordant for B-cell return and relapse developed significantly lower serum IgM and more low IgM episodes than concordant patients (P < 0.05). Patients with lower baseline sIg levels tended to develop persistent IgM and IgG hypogammaglobulinaemia, resulting from an accumulation of incremental decreases after repeat cycles. This was not due to lower numbers of returning B cells in those developing low sIgs. The association of low IgM in patients with a discordant pattern of relapse suggests that underlying defects in B cells relating to survival and maturation into Ig-secreting cells, as well as attrition of IgG plasma cells may be contributing to low sIg levels in some patients.

Serum immunoglobulin levels in male schizophrenic patients before and after olanzapine therapy

Objective: To evaluate the effect of olanzapine therapy on serum immunoglobulin levels (IgA, IgG, IgM) in male schizophrenic patients after 2 months of treatment by olanzapine at a daily dose of 20 mg. Patients and Methods: Twenty-eight patients with schizophrenia were included in this study, assessment of each case was done by a psychiatric, also included a 30 healthy subjects as a control group. Serum immunoglobulin concentrations were determined for both patients and controls by Mancini Radial Immuno-diffusion method using immunoglobulin kits. For the patients group and after 2 months therapy with olanzapine at a fixed daily dose of 20 mg, serum immunoglobulins were determined again using the same method for the assay. Results: No significant difference was found between serum levels of immunoglobulin (IgA, IgG, IgM) in schizophrenic patients before therapy in comparison to controls. Also insignificant difference was found between serum immunoglobulin levels (IgA, IgG, IgM) in schizophrenic patients after 2 months of olanzapine therapy and the controls. By comparing serum immunoglobulin levels in patients with schizophrenia before and 2 months after starting olanzapine therapy, no statistically significant difference was found. Conclusion: Olanzapine as atypical antipsychotic may not have an influence on the humoral immune response as reflected by the immunoglobulin levels (IgA, IgG, IgM)

Isolated Prolonged Prothrombin Time Correlates with Serum Immunoglobulin Levels in Patients with Multiple Myeloma

Abstract 1225▪▪This icon denotes a clinically relevant abstract Background:Secondary hemostatic defects resulting in bleeding diathesis occur in a subset of patients with plasma cell neoplasms due to a variety of mechanisms. Abnormal screening coagulation tests are frequently observed in asymptomatic patients with multiple myeloma and other plasma cell neoplasms. However, whether these coagulation abnormalities correlate with changes in serum proteins, diagnosis, or other disease parameters has not been systematically evaluated. Study Design:The objective of this study was to determine the prevalence of abnormal screening coagulation tests in patients with different plasma cell neoplasms and correlate clotting times with clinical history and diagnostic parameters. Methods:The medical records of 292 consecutive patients referred to the Myeloma Institute for Research and Therapy at UAMS from January 2010 to October 2010 were reviewed. Nineteen patients were excluded because they lacked screening coagulation tests or did not fulfill WHO diagnostic criteria for plasma cell neoplasm. Prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen activity were determined using mechanical detection. Abnormal APTT was defined as clotting times outside the normal range (23–36.9 sec). Prolonged PT was defined as ≥15.0 seconds (normal range: 11.5–14.7 sec) or INR > 1.2. Patients with prolonged PT or APTT due to warfarin therapy, liver disease or disseminated intravascular coagulation were also excluded. Results:A total of 79 patients had abnormal screening coagulation tests. An isolated prolonged PT was found in 62 patients (25%) and 10 patients had prolonged PT and APTT (3.5%). An isolated prolonged APTT was present in 2 patients (<1%) and decreased APTT seen in 5 patients (2%). According to the clinical notes, none of the patients had significant bleeding.Patients with isolated prolonged PT (62 total) and patients with normal screening tests (173 total) were compared with respect to age, fibrinogen, serum immunoglobulin level determined by protein electrophoresis, diagnosis, immunoglobulin isotype, and history of previous chemotherapy. There was no difference in age between patients with prolonged PT and those with normal PT (Table 1), previous chemotherapy or immunoglobulin isotype. Fibrinogen was significantly decreased in patients with prolonged PT (Table 1); however, there was no correlation between plasma fibrinogen and PT (p=0.1321). In contrast, serum immunoglobulin levels were significantly greater in patients with a prolonged PT (Table 1) and were positively correlated with PT (Figure 1).Table 1Patient CharacteristicsAll patients (mean ± SEM)PT < 15 sec (mean ± SEM)PT ≥ 15 sec (mean ± SEM)Age (yr)61.4 ± 0.71860.9 ± 0.83262.7 ± 1.415NSFibrinogen (mg/dL)414 ± 7.61427 ± 8.43377 ± 15.84p=0.0057Serum Immunoglobulin (g/dL)1.63 ± 0.1191.11 ± 0.0973.10 ± 0.287p<0.0001Values from patients with PT<15 sec were compared with those with PT≥15 sec using a Mann-Whitney (two-tailed) t-test. [Display omitted] As shown in Table 2, prolonged PT was more frequently observed in patients with multiple myeloma while patients with MGUS were less likely to have prolonged PT. No differences were observed with other plasma cell neoplasms; however, the numbers of patients in these diagnostic groups was small.Table 2:Patient DiagnosisDiagnosisAll PatientsPT <15 secPT ≥ 15 secORMultiple Myeloma (MM)157105523.37 (p=0.0009)MM, Non or Hyposecretory660NSMM with Plasmacytoma440NSSmoldering Myeloma21165NSMGUS343040.33 (p=0.037)Plasmacytoma11101NSAmyloid220NSTotal23517362Incidence of elevated PT in patients with indicated disease was determined by Fisher's exact test. Odds-Ratio (OR) was calculated using GraphPad Prism. Conclusion:An isolated prolonged PT (≥15 sec) was the most common abnormal coagulation test in our cohort. An association between disease severity and prolonged PT is suggested by our finding that patients with multiple myeloma were more likely to have prolonged PT than were patients with other plasma cell neoplasms. Of the factors examined, only serum immunoglobulin levels correlated with PT and were significantly elevated in patients with isolated prolonged PT. Disclosures:No relevant conflicts of interest to declare.

Increased serum immunoglobulin levels are common in mycosis fungoides and Sézary syndrome

Background: Patients with cutaneous T-cell lymphoma (CTCL; mycosis fungoides [MF] and Sézary syndrome [SS]) acquire immunodeficiency and opportunistic infections. Objective: We attempted to determine whether abnormalities of humoral immunoglobulin levels are present. Methods: A retrospective analysis of serum immunoglobulin levels in patients with CTCL at baseline evaluation at a cancer center was compared to levels in patients with leukemias and levels in healthy control subjects. Results: A total of 254 of 650 patients with CTCL evaluated between 1987 and 2001 had baseline quantitative immunoglobulin levels. Mean IgG, IgA, and IgM levels were similar among all MF/SS patients versus controls. The percentages of MF/SS patients with elevated levels of each immunoglobulin class were higher than percentages in healthy controls, and elevated IgA levels occurred among late versus early patients (P = .043). Conclusion: High immunoglobulin levels are more frequent in patients with MF and SS than in healthy controls, patients with chronic lymphocytic leukemia, and patients with hairy cell leukemia. High IgA levels are more frequent in late stage MF/SS. (J Am Acad Dermatol 2002;47:685-91.)

Serum immunoglobulin levels in patients with active pulmonary tuberculosis and patients with Klebsiella infection

Serum immunoglobulins levels were determined in 42 patients with active pulmonary tuberculosis as a prototype of chronic infection and 41 patients with Klebsiella infection representing acute infection, using a radial immunodiffusion technique. The mean serum concentration of IgG, IgA and IgM of the patients with pulmonary tuberculosis (1980 ± 688, 314 ± 152 and 222 ± 123 mg/dl, respectively) were found to be significantly higher than normal control levels ( P < 0.005). The mean serum IgG, IgA and IgM concentration of the patients with Klebsiella infection (1102 ± 340, 287 ± 133 and 168 ± 105 mg/dl, respectively), were also higher than normal levels but only IgM level differed significantly from the normal control levels ( P < 0.05). The difference in serum IgG and IgM between the patients with pulmonary tuberculosis and Klebsiella infection was statistically significant ( P < 0.05 and P < 0.05, respectively). These findings reflect the polyclonal hypergam-maglobulinemia found in chronic infections, on the one hand, and the rise of IgM of the primary immune response in acute infection, on the other.

Serum immunoglobulin levels in patients with head and neck cancer (IgE, IgA, IgM, IgG).

In the present study, 226 patients with squamous cell cancer of the head and neck, who had had undergone no antitumor therapy, were examined pretherapeutically for serum immunoglobulin levels (IgG, IgM, IgA, IgE). In cancer patients, significant elevations of mean levels of IgA and IgE were found in comparison to healthy controls (n = 100) and patients with chronic laryngitis (n = 63). IgG and IgM were in the range of the control groups. Levels above the upper limit were detected in 40.9% for IgE and 43.9% for IgA in the groups of cancer patients and in about 6% for both immunoglobulins in the control group. The group of patients with relapses in the follow-up were found to have pretherapeutically significantly higher levels of both IgE and IgA in comparison to those without evidence of disease for more than 6 months. These results point to the fact that determination of serum IgA and IgE levels in patients with head and neck cancer might be applicable as parameters for monitoring malignant disease, being additionally of some prognostic significance.

Impaired PWM-induced polyclonal B-cell activation in patients with malignancies treated with various intermittent combination chemotherapies including doxorubicin.

The effect of various intermittent combination chemotherapies on the immune status of 30 patients with malignancies was examined 1-3 weeks after they received their last injection. PWM-induced polyclonal B-cell activation of lymphocytes from patients treated with combination chemotherapies that included doxorubicin was impaired despite a normal 3H-thymidine uptake by lymphocytes stimulated with PHA, PWM, and insoluble SPA. This suppressive effect was always found in patients with ALL. However, in patients with solid tumors, PWM-induced immunoglobulin production returned to normal 7-8 weeks after the last doxorubicin injection. Serum immunoglobulin levels in patients treated with doxorubicin were slightly lower than in those treated without doxorubicin. It is hypothesized that doxorubicin may change the lymphocyte surface membrane and interrupt the T- and B-cell interaction that is needed for immunoglobulin production.

Serum immunoglobulin levels in patients with non-Hodgkin's lymphoma.

Immunoglobulin quantitation was performed on pretherapy sera from 120 patients who had non-Hodgkin's lymphoma in an attempt to correlate abnormalities with histologic cell type and pattern. Patients with diffuse lymphomas had significantly (P less than 0.05) higher levels of IgG and IgA than patients with follicular lymphomas. Furthermore, polyclonal hyperimmunoglobulinemia was overall more common than hypoimmunoglobulinemia, and abnormally high immunoglobulin levels were most frequently found in patients who had diffuse histologic patterns. The highest values were associated with either lymphomas composed of T (thymus-derived) cells or large B (bursa-derived) cells. The incidence of quantitative immunoglobulin abnormalities in patients with T-cell lymphomas was comparable with that in patients with B-cell lymphomas. These abnormalities in the former group of patients were exclusively above the normal range, whereas they were equally above and below the normal range in the latter group. The frequent polyclonal hyperimmunoglobulinemia in patients with T-cell lymphomas may be related to the pathophysiology of these lesions.

Serum immunoglobulin levels in patients having sickle cell syndromes.

Serum immunoglobulin concentrations were measured for 44 patients who had sickle cell syndromes and for 19 normal black individuals. Most patients who had sickle cell syndrome had significantly elevated IgA levels. In addition, patients who had sickle cell anemia had elevated IgG levels, and patients who had sickle-beta-Thalassemia or other sickle combinations (SC, SD, SO) had significantly elevated IgM levels. None of these patients had a monoclonal gammopathy. The elevated immunoglobulin levels could be the result of chronic reticuloendothelial stimulation by chronic extravascular hemolysis or by potentiation by the inflammation secondary to cholecystitis and cholelithiasis. The reason patients with sickle cell anemia do not have increased IgM levels could be due to their functional asplenia.

Serum immunoglobulin levels in patients with neuroblastoma and their prognosis

Serum IgG, IgA, IgM and β1A globulin levels of 24 patients with neuroblastoma were measured for the purpose of determining whether or not humoral immune competence of these patients is related to their prognosis. As control groups, 39 normal children and 21 patients with other melignant neoplasia such as leukemia and malignant lymphoma were measured for these globulin levels. On admission, the serum IgG level was high in 7/16 (43.8%) of the neuroblastoma patients, in 0/39 (0%) of the normal children and in 2/21 (9.5%) of the other malignancies (>M+2 SD). β1A globulin level was high in 10/16 (62.5%), 0/39 (0%) and 8/21 (38.1%) of the cases, respectively. Serum IgG and β1A globulin levels were observed to be higher in patients with neuroblastoma than in normal children and patients with other malignancies. Six of these 16 neuroblastoma patients are still alive: 3 with long survival with metastatic tumor and 3 with long survival without tumor. Four of these 6 patients, the first 3 cases and one of the latter cases, had very high IgG levels on admission (>M+3 SD). There were no significant differences between neuroblastoma, other malignancy and normal children in serum IgA and IgM levels. During serial measurement of these globulins in the 14 dying cases, serum IgG level decreased abruptly 2–4 mo after the initial treatment whereas the initial high levels continued in all of the living cases. β1A globulin registered high levels on admission in both dying and living patients and gradually decreased during treatment. All 4 cases with recovery showed normal ranges (M+1 SD). As a result, patients who showed a higher level of IgG at admission and did not have decreased IgG and IgM levels during treatment seemed to be long survival cases. We think that these data suggest that the humoral immune competence of the patients with neuroblastoma may be related to their prognosis. Serum IgG, IgA, IgM and β1A globulin levels of 24 patients with neuroblastoma were measured for the purpose of determining whether or not humoral immune competence of these patients is related to their prognosis. As control groups, 39 normal children and 21 patients with other melignant neoplasia such as leukemia and malignant lymphoma were measured for these globulin levels. On admission, the serum IgG level was high in 7/16 (43.8%) of the neuroblastoma patients, in 0/39 (0%) of the normal children and in 2/21 (9.5%) of the other malignancies (>M+2 SD). β1A globulin level was high in 10/16 (62.5%), 0/39 (0%) and 8/21 (38.1%) of the cases, respectively. Serum IgG and β1A globulin levels were observed to be higher in patients with neuroblastoma than in normal children and patients with other malignancies. Six of these 16 neuroblastoma patients are still alive: 3 with long survival with metastatic tumor and 3 with long survival without tumor. Four of these 6 patients, the first 3 cases and one of the latter cases, had very high IgG levels on admission (>M+3 SD). There were no significant differences between neuroblastoma, other malignancy and normal children in serum IgA and IgM levels. During serial measurement of these globulins in the 14 dying cases, serum IgG level decreased abruptly 2–4 mo after the initial treatment whereas the initial high levels continued in all of the living cases. β1A globulin registered high levels on admission in both dying and living patients and gradually decreased during treatment. All 4 cases with recovery showed normal ranges (M+1 SD). As a result, patients who showed a higher level of IgG at admission and did not have decreased IgG and IgM levels during treatment seemed to be long survival cases. We think that these data suggest that the humoral immune competence of the patients with neuroblastoma may be related to their prognosis.

Serum immunoglobulin levels in patients suffering from chronic and recurrent chest infections.

Using a single radial diffusion technique the serum levels of IgA, IgG and IgM were estimated in sixty healthy members of the hospital staff, seventy-two patients suffering from bronchiectasis and forty-two patients suffering from chronic bronchitis and/or recurrent pneumonia. Two patients, both with bronchiectasis, were found to have hypogamma-globulinaemia. Two patients had low levels of IgA, and six patients had subnormal levels of IgM. The fact that deficiency of IgM was found in chest disease sufferers more frequently than in healthy individuals suggests that this form of dysglobulinaemia may be a relevant factor in the occurrence of repeated episodes of chest infection. It may thus be possible to identify a group of patients who are likely to suffer respiratory disablement and to take measures to prevent or delay this complication.

Serum immunoglobulin levels throughout the life-span of healthy man.

Serum immunoglobulin concentrations in apparently healthy subjects vary with age, race, and sex. Meaningful interpretation of serum immunoglobulin concentrations in older adults has been difficult because of normal variation. A new method for characterizing means and confidence intervals of IgG, IgA, and IgM makes it possible to evaluate observations in a single patient independent of confounding physiologic variation. The derived confidence intervals and categories of altered levels of IgG, IgA, and IgM observed in healthy subjects are comparable between all race and sex groups from age 1 to 80 years. The confidence interval bounded by two standard deviations about the mean excludes 5% of apparently healthy controls. Elevated IgM, low IgA, low IgG, low IgM, and elevated IgA are the commonest changes observed in apparently healthy humans. The data presented provide a basis for evaluation and interpretation of serum immunoglobulin levels in patients throughout life.

Serum immunoglobulin levels in patients with sickle cell disease

The serum immunoglobulins IgG, IgA and IgM were determined in thirty Negro patients with sickle cell disease and in thirty healthy Negro subjects. A statistically significant elevation of the mean serum IgG and IgA levels was found in the patients with sickle cell disease. No significant difference was noted in the mean IgM level. The reasons for these changes are not fully understood and may be related in part to liver damage, chronic infection and genetic factors.

The influence of corticosteroid therapy on the serum immunoglobulin levels in patients with viral hepatitis

The influence of corticosteroid therapy on the serum immunoglobulin levels in patients with viral hepatitis