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B lymphocyte subsets and outcomes in patients with an initial diagnosis of transient hypogammaglobulinemia of infancy
Author(s) -
Eroglu Fehime K.,
Aerts Kaya Fatima,
Cagdas Deniz,
Özgür Tuba Turul,
Yılmaz Togay,
Tezcan İlhan,
Sanal Özden
Publication year - 2018
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12709
Subject(s) - hypogammaglobulinemia , immunoglobulin d , medicine , immunology , b cell , immunodeficiency , pediatrics , memory b cell , antibody , gastroenterology , immune system
Purpose Transient hypogammaglobulinemia of infancy ( THI ) is a common immunodeficiency, but definitive diagnosis can only be made retrospectively. While the pathogenesis is still unknown, abnormalities have been reported in the B cell compartment. In this study, we analysed the B cell subsets of patients with an initial THI diagnosis (n = 20) and compared them with those of healthy age‐matched Turkish children (n = 72). Methods Flow cytometric analyses of the B subsets were performed by staining with anti‐ CD 27‐ PE , anti‐ CD 19‐Per CP , anti‐IgD‐ FITC and anti‐IgM‐ APC antibodies. Results During a median follow‐up of 6.6 years, 13 patients whose IgG levels had normalized before they reached four years of age were diagnosed with definitive THI . The memory subsets of these patients were lower but not statistically different from the healthy controls ( HC ). The remaining seven patients had prolonged hypogammaglobulinemia after the age of four and had significantly lower memory B cell subsets compared to the HC . On follow‐up, these patients had not experienced recurrent infections or autoimmunity. Re‐evaluation of patients’ B cell subsets six years later showed that the memory B cell ratios had increased to levels comparable to HC , despite the patients still having mildly low IgG levels. Conclusion Patients with prolonged hypogammaglobulinemia had lower levels of memory B cells despite having a similar clinical course to patients who had been diagnosed with definitive THI . This subgroup of putative THI patients poses a diagnostic and classification dilemma. Our results suggested that these patients’ memory B cells and IgG levels may recover over time.