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Transient infantile hypogammaglobulinemia: symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Transient infantile hypogammaglobulinemia (TIH) is defined as a significant decrease in IgG levels with or without deficiency of other immunoglobulin classes in a child older than 6 months, provided that other immunodeficiency conditions have been excluded.
Pathogenesis
The mechanism of transient infantile hypogammaglobulinemia is not known for certain, but several pathogenesis variants of this condition have been proposed: defect in T-lymphocyte maturation, abnormalities in cytokine synthesis, the presence of maternal anti-IgG antibodies that inhibit the synthesis of their own. However, in all cases of transient infantile hypogammaglobulinemia, immunoglobulin levels normalize with age.
Symptoms
Patients with transient hypogammaglobulinemia often have an increased incidence of infectious diseases, mostly non-life-threatening. Mostly, otitis media, sinusitis, and bronchitis occur. Severe infections caused by opportunistic flora, continuing in children over 2-3 years of age, are not typical for this condition.
Diagnostics
The diagnostic criteria for this condition are not fully standardized. It is believed that transient hypogammaglobulinemia is indicated by a decrease in the concentration of one or more immunoglobulin isotypes by more than two standard deviations from the age norm. At the same time, the synthesis of specific antibodies, the levels of T- and B-cells correspond to the age norm.
Treatment
Patients with transient hypogammaglobulinemia usually do not show a deficiency in specific antibody formation. Replacement therapy is not indicated for such patients. Only in severe bacterial infections (especially those caused by pneumococcus, N.influenzae, meningococcus) intravenous immunoglobulin is prescribed to such children, given that the synthesis of antibodies against polysaccharide antigens is delayed in young children.
Forecast
In the absence of other defects, the condition corrects itself and does not require treatment.
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