DeBaets F, Kint J, Pauwels R, Leroy J
Department of Paediatrics, University Hospital, Ghent, Belgium.
Eur J Pediatr. 1992 Apr;151(4):274-8. doi: 10.1007/BF02072228.
We studied the incidence of IgG subclass deficiency in children with recurrent bronchitis. Recurrent bronchitis was defined as three or more episodes a year during at least 2 consecutive years, of bronchopulmonary infection, productive cough with or without fever and/or diffuse râles by physical examination in the absence of asthma or atopy. Fifty three children were selected, of whom 30 (57%) were deficient in one of the IgG subclasses. None had an IgG1 deficiency. Nine (17%) were deficient in IgG2, 9 (17%) in IgG3 and 20 (38%) in IgG4. Isolated IgG subclass deficiencies were most frequently seen for IgG4 (14, 26%), less for IgG3 (6, 12%) and even less for IgG2 (4, 7%). Nine (17%) children were IgA deficient and 8 (15%) IgG deficient with a combined IgG subclass deficiency in 8 and 7 of them respectively. By subdivision into different age groups most patients were encountered in the youngest group. The mean content of IgG2, IgG3 and IgG4 in 3- to 4-year-old children with recurrent bronchitis was significantly lower than in the age matched controls. The mean value for IgG4 in the 5- to 6-year-olds was significantly lower than in the control group. This study demonstrates the correlation between recurrent bronchitis in childhood and IgG subclass deficiency. IgG subclass deficiency and recurrent bronchitis are both quite prominent phenomena in young children but rare in older children, suggesting a transient immaturity of the immune system as one of the possible pathogenetic factors. An IgA or an IgG deficiency is highly suggestive for the existence of a combined IgG subclass deficiency.
我们研究了复发性支气管炎患儿中IgG亚类缺陷的发生率。复发性支气管炎定义为在至少连续2年中，每年发生3次或更多次支气管肺部感染，伴有或不伴有发热的咳痰性咳嗽和/或体格检查发现弥漫性啰音，且无哮喘或特应性体质。选取了53名儿童，其中30名（57%）存在一种IgG亚类缺陷。无人存在IgG1缺陷。9名（17%）存在IgG2缺陷，9名（17%）存在IgG3缺陷，20名（38%）存在IgG4缺陷。孤立的IgG亚类缺陷最常见于IgG4（14名，26%），其次是IgG3（6名，12%），IgG2最少（4名，7%）。9名（17%）儿童存在IgA缺陷，8名（15%）存在IgG缺陷，其中分别有8名和7名同时存在IgG亚类联合缺陷。按不同年龄组细分后，大多数患者出现在最年幼的组中。3至4岁复发性支气管炎患儿的IgG2、IgG3和IgG4平均含量显著低于年龄匹配的对照组。5至6岁儿童的IgG4平均值显著低于对照组。本研究证明了儿童复发性支气管炎与IgG亚类缺陷之间的相关性。IgG亚类缺陷和复发性支气管炎在幼儿中均相当突出，但在大龄儿童中罕见，提示免疫系统的短暂不成熟是可能的致病因素之一。IgA或IgG缺陷强烈提示存在IgG亚类联合缺陷。
