Apparent impairment of primary antibody response with intact immunological memory.

A 46-year-old woman with repeated skin infections, sore throats, laryngitis and abscesses was investigated because of low gammaglobulin on serum electrophoresis. When tested for ability to form antibodies to several antigens the patient did not respond to primary antigenic stimuli with H or O antigens, or with keyhole limpet haemocyanin (KLH). However, she had a good secondary response to numerous agents with which she had previous contact (tetanus, diphtheria, polio and specific blood group substances). The selective impairment of cells capable of giving a primary immune response in the presence of intact memory cells gives support to the concept of a qualitative difference between these two types of cells.