Allergy Asthma Proc. 2024 Sep 1;45(5):317-320. doi: 10.2500/aap.2024.45.240055.
Immunoglobulin G (IgG) subclass deficiencies and isolated IgA, IgM, IgE deficiencies have all been described in the literature with variable prevalence. These isotype deficiencies have a variable presentation from asymptomatic to recurrent infections resistant to prophylactic antibiotics. Atopic disorders and autoimmune diseases are common comorbidities. IgE deficiency has been associated with impaired vaccine response and an increased risk of malignancy, particularly in patients with no allergic comorbidities and those with non-common variable immunodeficiency (CVID) humoral immunodeficiency, IgM deficiency, IgG2 deficiency, and CD4 lymphopenia. Close monitoring for malignancy should be strongly considered for these patients who are at risk. Treatment is variable and may include antimicrobial therapies for illnesses and prophylactic antibiotics in select patients, and immunoglobulin replacement can be considered for patients with refractory, recurrent infections.
免疫球蛋白 G (IgG) 亚类缺陷和孤立的 IgA、IgM、IgE 缺陷在文献中均有描述，其流行率各不相同。这些同种型缺陷的表现从无症状到对抗生素预防治疗无效的复发性感染不等。特应性疾病和自身免疫性疾病是常见的合并症。IgE 缺陷与疫苗反应受损以及恶性肿瘤风险增加有关，特别是在无过敏合并症的患者和非常见可变免疫缺陷 (CVID) 体液免疫缺陷、IgM 缺陷、IgG2 缺陷和 CD4 淋巴细胞减少症患者中。对于这些有风险的患者，应强烈考虑进行恶性肿瘤的密切监测。治疗方法多种多样，可能包括针对疾病的抗菌治疗和选择性患者的预防性抗生素治疗，对于难治性、复发性感染的患者，可以考虑免疫球蛋白替代治疗。
