Midwest Immunology Clinic & Infusion Center, MN 55446, USA.
Immunotherapy. 2012 Dec;4(12):1835-9. doi: 10.2217/imt.12.130.
To report the interesting case of a patient with common variable immune deficiency disease who demonstrated varied responses to intravenous (IV) and subcutaneous (SC) immunoglobulin (Ig) therapy with regard to both infection frequencies and IgG3 subclass determinations.
PATIENT & METHODS: As part of routine medical care, the author monitored total and IgG subclass levels, along with infection frequencies in a 35-year-old woman, with recurrent sinopulmonary infections diagnosed with common variable immune deficiency disease.
During treatment with IVIg, the patient's annual rate of infections decreased, although she experienced severe headaches. After being switched to daily SCIg therapy, the headaches stopped, and her annual infection rate declined further. Her IgG3 levels, which were undetectable during IVIg therapy, increased substantially during SCIg treatment.
The reason for the observed correlation between IgG3 level restoration and a decline in infection rate after being switched to SCIg therapy is not entirely clear. At the minimum, it may suggest that IgG3 levels may be a simple and useful surrogate marker to monitor Ig replacement sufficiency in certain patients.
报告一例常见变异性免疫缺陷病患者的有趣病例，该患者在静脉（IV）和皮下（SC）免疫球蛋白（Ig）治疗方面对感染频率和 IgG3 亚类测定均表现出不同的反应。
作为常规医疗护理的一部分，作者监测了一名 35 岁女性的总 IgG 亚类水平和感染频率，该女性患有常见变异性免疫缺陷病，反复发生鼻窦和肺部感染。
在接受 IVIg 治疗期间，尽管患者出现严重头痛，但每年感染率下降。在转换为每日 SCIg 治疗后，头痛停止，每年感染率进一步下降。在接受 SCIg 治疗期间，她的 IgG3 水平显著升高，而在 IVIg 治疗期间，该水平无法检测到。
在转换为 SCIg 治疗后观察到 IgG3 水平恢复与感染率下降之间的相关性的原因尚不完全清楚。至少可以表明，在某些患者中，IgG3 水平可能是监测 Ig 替代充足性的简单而有用的替代标志物。
