[Immunological confirmation of allergy in children with hypoimmunoglobulinemia]

The recognition of allergy in children with hypoimmunoglobulinemia is very difficult because they have very low level or even lack of specific IgE antibodies. Our research hypothesis was the possibility of detecting the specific sensitization of lymphocytes T to food allergens in children with hypoimmunoglobulinemia and with clinical symptoms of allergy.

32 children actually treated in our Immunology Outpatients Department due to immunodeficiency connected with hypoimmunoglobulinemia and with clinical suspicion of allergy.

IgE concentration in serum and IgE specific antibodies to food and pollens were examined by FEIA CAP-SYSTEM. Lymphocyte specific response to allergens (cow's milk, gluten) was examined by classical blast transformation test. Immunological profile of children was also evaluated.

In the group of 32 children we recognised: 20 children with predominantly antibody deficiencies (2 - agammaglobulinemia; 8 - CVID; 5 - selective immunoglobulins deficiency; 5 - hypoimmunoglobulinemia of infants) and 12 children who had combined immunodeficiency with hypoimmunoglobulinemia ( 3 - AT; 8 - Nijmegen S; 1 - Di George). The children had atopic dermatitis and clinical symptoms of allergy in respiratory and digestive tracts. Concentration of IgE in serum of children was very low, even < 2KU/L, Pediatric Phadiatop was negative, f2 and f79 were absent. Using lymphocytes transformation test (culture stimulated with cow's milk and gluten antigens) we detected sensitivity to cow's milk in 24 children and additionally in 4 of them sensitivity to gluten.

1) Laboratory difficulties in allergy diagnosis in children with hypoimmunoglobulinemia by evaluation of specific IgE concentration in serum may by caused by defect in biosynthesis of mentioned antibodies. 2) In children with hypoimmunoglobulinemia the lymphocyte blastic transformation test with specific allergens in cultures has a diagnostic value indicating lymphocytes specific response to allergens.