SERUM IMMUNOGLOBULINS. II. LEVELS IN CHILDREN SUBJECT TO RECURRENT INFECTION

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Abstract
In serum immunoglobulin analyses of 600 children reported to be subject to frequent respiratory or cutaneous infection, 263 (44%) demonstrated concentrations of one or more immunoglobulins which were outside the normal bounds for age. In contrast, similar analyses in 181 normal subjects of comparable ages revealed only 14 sera (7.7%) which had immunoglobulin concentrations outside normal bounds (normal bounds = antilogs of the mean logs of the normal subject data at each of 18 ages ± two pooled standard deviations of the logs). A chi square test comparing the number of sera in each group with values outside the normal bounds revealed a highly signicant difference (p < 0.0001) between the two groups. The abnormalities observed fell into 11 different categories of multiple or single immunoglobulin alterations. No particular type or focus of infection distinguished any one category from another. Infections were somewhat more severe in subjects with multiple immunoglobulin deficiencies. Clinical allergy was observed frequently in 9 of the 11 categories. These studies strongly suggest that immunoglobulin abnormalities are more common than published reports indicate. The detection of such abnormalities is not an indication for arbitrary gamma-globulin therapy but for further immunologic evaluation.

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