Ekdahl K, Rollof J, Oxelius V A, Engellau J, Braconier J H
Department of Infectious Diseases, Lund University Hospital, Sweden.
Eur J Clin Microbiol Infect Dis. 1994 May;13(5):374-8. doi: 10.1007/BF01971993.
In 48 patients with a history of a pneumococcal bacteremia, serum taken during the acute phase of the infection was analyzed for IgG and IgG subclasses. Once the patients were free of infection, a serum sample was analyzed for IgG, IgG subclasses, IgA and IgM. In an additional 20 patients, it was only possible to analyze serum from the infection-free phase. Seventeen of 48 (35%) patients had reduced levels of total IgG or of one or more of the IgG subclasses during acute disease. Of the 48 patients in whom both acute phase and infection-free phase serum were analyzed, values of IgG (p < 0.001), IgG1 (p < 0.001), IgG2 (p < 0.001), IgG3 (p < 0.01) and IgG4 (p < 0.01) were decreased during the acute infection. During the infection-free phase, 12 of 68 (18%) patients had a recognizable immunodeficiency, including two patients with common variable immunodeficiency. Routine screening for immunoglobulins during the infection-free period could result in the discovery of previously unrecognized immunoglobulin deficiencies in patients with a history of bacteremic pneumococcal infection.
对48例有肺炎球菌菌血症病史的患者，分析其感染急性期采集的血清中的IgG及IgG亚类。待患者感染消除后，分析其血清样本中的IgG、IgG亚类、IgA和IgM。另外20例患者仅能分析感染消除期的血清。48例患者中有17例（35%）在急性期总IgG水平或一种或多种IgG亚类水平降低。在分析了急性期和感染消除期血清的48例患者中，急性感染期间IgG（p<0.001）、IgG1（p<0.001）、IgG2（p<0.001）、IgG3（p<0.01）和IgG4（p<0.01）水平均下降。在感染消除期，68例患者中有12例（18%）存在可识别的免疫缺陷，其中包括2例常见可变免疫缺陷患者。在感染消除期对免疫球蛋白进行常规筛查，可能会发现有菌血症性肺炎球菌感染病史的患者中先前未被识别的免疫球蛋白缺陷。
