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SELECTED ARTICLES FROM THE RECENT LITERATURE 2008

10/9/07

Assessment in clinical interpretation of reduced IgG values

Summary
Allergen immunologists are often confronted with patients referred because of recurrent respiratory tract infections and modestly low immunoglobulin levels. The decision as to whether or not to initiate immunoglobulin replacement therapy often is difficult and there is no formal algorithm which makes that decision automatic.

Reference
Agarwal S and Cunningham-Rundles C., Annals of Allergy, Asthma, and Immunology 2007; 90:281-283.

Editor's Comments
This article deals specifically with this issue in a very concise manner. Pertinent points were as follows:

  1. Immunoglobulin deficiency is classified as profound with levels of IgG less than 100 mg/dl, significant when levels are 100-299 mg/dl. A level of 300-600 mg/dl is considered a mild to moderate reduction.
  2. When replacement therapy is initiated, it is reasonable to maintain a serum IgG level of greater than 600 mg/dl.
  3. Higher levels (greater than 800 mg/dl) would be more beneficial in terms of pulmonary outcomes.

 

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