Immunoglobulins (Ig) A and G subclass deficiencies are common
immune system disorders which cause morbidity especially between 2 and 6 yr of age. Prognosis of these defects and therapeutic approach is unclear. The aim of the present retrospective study was to review the clinical and laboratory records of 87 children with
IgA and/or
IgG subclass deficiency to determine whether these patients experience changes in serum Ig concentrations during follow-up and to give more clinic and laboratory information to the families about the course of these diseases. Among 87 patients studied, the most frequent defect was partial
IgA deficiency combined with
IgG3 subclass deficiency (41%). The other groups were as follows; partial
IgA deficiency (32%), selective
IgA deficiency (8%), partial
IgA combined with IgG2-G4 subclass deficiency (6%), and
IgG subclass deficiency (13%). The commonest clinical presentations were recurrent
upper respiratory tract infections (76%),
pneumonia (14%), acute
gastroenteritis (3%), urinary tractus
infection (3%),
sinusitis (2%), and acute
otitis media (2%). Atopy was widely represented in the patients studied (24%). The number of patients who were given prophylactic treatment with
benzathine penicilline, prophylactic oral
antibiotic, or oral
bacterial extract to prevent
infections was 68 (78%). Frequency of
recurrent infections decreased from 7.9 +/- 4.9 per year to 2.5 +/- 2.3 in 68 patients receiving any prophylactic regimen; however, decrease in frequency of
infections did not show any significant difference between different prophylactic groups. None of the patients in the selective
IgA deficiency group had reached normal serum levels of
IgA. At the age of 58.3 +/- 21.4 months, 52% of patients in partial
IgA deficiency group and 51% of patients in partial
IgA +
IgG subclass deficiency group, serum
IgA increased to normal ranges. Serum
IgG subclass levels increased to normal range for age in 67% of patients in partial
IgA +
IgG subclass deficiency group and in 30% of patients in isolated
IgG subclass deficiency group. The mean age for reaching age-related normal
IgG subclass levels for these patients was 69.0 +/- 14.5 months. In conclusion, findings of this study suggest that
IgA and/or
IgG subclass deficiency may be either progressive or reversible disorders and emphasize the value of monitoring Ig levels in affected individuals.