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Immunoglobulin G Deficiency in Children with Recurrent Respiratory Infections with and Without History of Allergy
Aleksandra Lewandowicz-Uszyńska1,2, Gerard Pasternak3,4, Katarzyna Pentoś5
1Third Department and Clinic of Pediatrics, Immunology and Rheumatology of Developmental Age, Wroclaw Medical University, Wroclaw, Poland.
Insights
Recurrent respiratory tract infections (RTI) in children are common. This study found no distinct immunoglobulin G (IgG) abnormalities linked to allergies, suggesting IgG testing is not helpful for diagnosing allergies in children with recurrent RTIs.
Area of Science:
- Pediatric Immunology
- Allergy and Immunology
- Infectious Diseases
Background:
- Recurrent respiratory tract infections (RTI) are frequent in childhood and can suggest immunodeficiency.
- Allergies are often considered a contributing factor to recurrent RTIs in children.
Purpose of the Study:
- To investigate immunoglobulin G (IgG) profiles in children with recurrent RTIs, with and without a history of allergy.
- To determine if specific IgG subclass deficiencies are associated with allergies in children experiencing recurrent RTIs.
Main Methods:
- Retrospective analysis of medical records from 524 children hospitalized with RTI.
- Patients were categorized into two groups: RTI-alone and RTI with a history of allergy.
- Evaluation of immunoglobulin G (IgG) levels and IgG subclass deficiencies.
Main Results:
- Most children with RTI had normal immunoglobulin G (IgG) levels, regardless of allergy history.
- IgG subclass deficiencies, particularly IgG1, IgG3, and IgG4, were found in less than one-third of children and were similar between groups.
- IgG deficiencies increased with age, independent of allergy status, with a slightly lower prevalence of IgG4 deficiency in the allergy group.
Conclusions:
- There are no distinct immunoglobulin G (IgG) profile abnormalities characteristic of allergies accompanying recurrent RTIs in children.
- Assessment of IgGs is unlikely to aid in the differential diagnosis of allergic backgrounds in children with recurrent RTIs.
Abstract:
Recurrent respiratory tract infections (RTI) are one of the most common diseases in childhood. Frequent infections adversely affect the development of a child and may lead to suspicion of immunodeficiency. An additional allergy component is thought conducive to infection occurrence. In this study, we retrospectively assessed medical records of 524 children hospitalized with RTI. Patients were divided into two groups: RTI-alone (n = 394) and RTI with a history of allergy (n = 130). Overall, we found that a great majority of children with RTI had the immunoglobulin G within the normal limit, irrespective of allergy. A variable IgG deficiency, most often affecting IgG1, IgG3, and IgG4 subclass, was present in less than one-third of children. Proportions of specific IgG subclass deficiency, varying from about 10% to 40%, were similar in both RTI-alone and RTI-allergy groups. The only significant effect was a modestly smaller proportion of children with IgG4 deficiency in the RTI-allergy group when compared with the RTI-alone group. We also found that IgG deficiencies were age-dependent as their number significantly increased with children's age, irrespective of allergy. The results demonstrate a lack of distinct abnormalities in the immunoglobulin G profile which would be characteristic to a clinical history of allergy accompanying recurrent RTI in children. Thus, we conclude that the assessment of IgGs could hardly be of help in the differential diagnostics of the allergic background of RTI.
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