K. Ekdahl et al., ANALYSIS OF IMMUNOGLOBULIN ISOTYPE LEVELS IN ACUTE PNEUMOCOCCAL BACTEREMIA AND IN CONVALESCENCE, European journal of clinical microbiology & infectious diseases, 13(5), 1994, pp. 374-378
In 48 patients with a history of a pneumococcal bacteremia, serum take
n 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-fr
ee 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 t
he 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 %) pat
ients had a recognizable immunodeficiency, including two patients with
common variable immunodeficiency. Routine screening for immunoglobuli
ns during the infection-free period could result in the discovery of p
reviously unrecognized immunoglobulin deficiencies in patients with a
history of bacteremic pneumococcal infection.