Bartmann P, Kleihauer E
Universitäts-Kinderklinik Abteilung II, Ulm, Federal Republic of Germany.
Eur J Pediatr. 1988 Dec;148(3):211-4. doi: 10.1007/BF00441405.
A total of 210 patients with repeated infections were screened for IgG4 deficiency. In 30 patients (14%) IgG4 was undetectable by radial immunodiffusion (less than 30 mg/l). Of these patients 17 (57%) were less than 2 years of age. Concomitant IgA deficiency (IgA less than 0.05 g/l) was demonstrated in 11 cases (37%). IgG2 serum levels below the normal range were found in 26 children. IgG4 could be demonstrated at a concentration of 0.5-29 mg/l in all 30 patients using a more sensitive enzyme-linked immunosorbent assay technique. Although a highly selected group of patients was investigated, the percentage of individuals without detectable IgG4 by immunodiffusion was in the same range as reported in the literature for healthy control persons. It is thus concluded that IgG4 serum reference levels have to be defined using more sensitive methods and that the observed severe infections are more likely to be connected with low serum IgG2 and/or IgA levels than undetectable IgG4 as measured by immunodiffusion.
共对210例反复感染患者进行了IgG4缺乏症筛查。通过放射免疫扩散法，在30例患者（14%）中未检测到IgG4（低于30mg/l）。这些患者中，17例（57%）年龄小于2岁。11例（37%）患者同时存在IgA缺乏（IgA低于0.05g/l）。26名儿童的IgG2血清水平低于正常范围。使用更敏感的酶联免疫吸附测定技术，在所有30例患者中均检测到浓度为0.5 - 29mg/l的IgG４。尽管研究的是一组经过高度筛选的患者，但通过免疫扩散法未检测到IgG4的个体比例与文献报道的健康对照人群范围相同。因此得出结论，必须使用更敏感的方法来定义IgG4血清参考水平，并且观察到的严重感染更可能与血清IgG2和/或IgA水平低有关，而不是与免疫扩散法测量的未检测到的IgG4有关。
