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Transient infant hypogammaglobulinemia: symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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Transient infant hypogammaglobulinemia (TMG) is defined as a significant decrease in the level of IgG with or without deficiency of other classes of immunoglobulins in a child over 6 months, provided that other immunodeficiency conditions are excluded.
Pathogenesis
The mechanism of transient infant hypogammaglobulinemia is not known, but several variants of the pathogenesis of this condition have been proposed: the defect of maturation of T-lymphocytes, cytokine synthesis anomalies, the presence of maternal anti-IgG antibodies inhibiting the synthesis of intrinsic ones. However, in all cases of transient infant hypogammaglobulinemia, normalization of the level of immunoglobulins occurs with age.
Symptoms
Among patients with transient hypogammaglobulinemia, the incidence of infectious diseases, mostly not life threatening, is often increased, mainly otitis media, sinusitis and bronchitis. Severe infections caused by conditionally pathogenic flora, which continue in children older than 2-3 years, are not typical for this condition.
Diagnostics
Criteria for diagnosing this condition are not completely standardized. It is believed that transient hypogammoglobulinemia is said to decrease the concentration of one or more immunoglobulin isotypes by more than a standard deviation from the age norm. In this case, the synthesis of specific antibodies, the levels of T- and B-cells correspond to the age-related diet.
Treatment
Patients with transient hypogammoglobulinemia usually do not show a deficit of specific antibody formation. Substitution therapy for such patients is not indicated. Only in cases of severe bacterial infections (especially those caused by pneumococcus, N.influenzae, meningococcus) Intestinal immunoglobulin is prescribed for ggg children, given that young children are delayed the synthesis of antibodies against polysaccharide antigens.
Forecast
In the absence of other defects, the condition is corrected by itself and does not require treatment.
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