Secondary hypogammaglobulinaemia
Hypogammaglobulinaemia is defined as reduced serum immunoglobulin (antibody) levels. It can be primary (congenital) or secondary. It can present in childhood and in adults, and can affect both sexes.
Primary hypogammaglobulinaemia may have a delay of several years between clinical presentation and diagnosis. The most common cause is common variable immunodeficiency.
Secondary hypogammaglobulinaemia may occur in:
- chronic lymphocytic leukaemia
- multiple myeloma
- myotonic dystrophy
Increased loss of immunoglobulins can also be associated with protein-losing enteropathy (such as from inflammatory bowel disease, autoimmune enteropathy, intestinal lymphangiectasia) or severe nephrotic syndrome - although most patients with nephrotic syndrome have preserved immunoglobulin levels.
Reference
- Otani IM, Lehman HK, Jongco AM, et al. Practical guidance for the diagnosis and management of secondary hypogammaglobulinemia: a Work Group report of the AAAAI Primary Immunodeficiency and Altered Immune Response Committees. J Allergy Clin Immunol. 2022 May;149(5):1525-60.
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