Impact of trough IgG on pneumonia incidence in primary immunodeficiency: A meta-analysis of clinical studies

Orange, Jordan S.; Grossman, William; Navickis, Roberta J.; Wilkes, Mahlon M.

doi:10.1016/j.clim.2010.06.012

Cited by 359 publications

(286 citation statements)

References 38 publications

Supporting

Mentioning

259

Contrasting

Unclassified

Order By: Relevance

“…29 As in primary antibody deficiencies, the dosages of substitutive therapy were also upward adjusted as needed to minimize infection, identifying the 'biological' IgG trough level effective in each patient. 30 The mean Ig monthly dose needed was almost identical for IVIg and SCIg even after individualization. The higher trough level of serum IgG achieved with SCIg can be explained by pharmacokinetic studies on immunoglobulin replacement therapy in primary hypogammaglobulinemia: the lower level of IgG achieved with IVIg despite a superimposable dosage is due to the rapid decrease in IgG level between two subsequent infusions from peak post-infusion to trough level.…”

Section: Discussionmentioning

confidence: 95%

Subcutaneous immunoglobulin in lymphoproliferative disorders and rituximab-related secondary hypogammaglobulinemia: a single-center experience in 61 patients

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 95%

Subcutaneous immunoglobulin in lymphoproliferative disorders and rituximab-related secondary hypogammaglobulinemia: a single-center experience in 61 patients

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The microorganisms involved in pneumonia in PID patients are shown in the Table. In patients with PID, pneumonia can be severe and require high-dose immunoglobulin replacement therapy, intravenous antibiotics, and/or hospitalization. Immunoglobulin replacement therapy is useful in PID patients with pneumonia, as it increases the level of IgG to at least the mid-normal range [56]. By preventing pneumonia, treatment with immunoglobulin can also decrease accompanying complications, such as bronchiectasis and chronic lung disease.…”

Section: Pneumoniamentioning

confidence: 99%

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Yazdani

Abolhassani

et al. 2017

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

Primary immunodeficiency disorders (PIDs) are caused by 1 or more defects of the immune system. Patients are more likely to experience recurrent and/or severe infections and tend to develop a wide range of complications. Respiratory diseases are the main and initial manifestation in most cases and the most common complication. Pulmonary complications cause significant morbidity and mortality in patients with PIDs. Early diagnosis and appropriate treatment can prevent or at least slow the development of respiratory complications. Since the spectrum of pulmonary complications in PIDs is broad, we divided pulmonary complications into upper respiratory complications (eg, sinusitis, otitis media, and laryngeal angioedema) and lower respiratory complications (eg, pneumonia, bronchitis, bronchiectasis, interstitial lung diseases, organizing pneumonia, pulmonary adenopathies and malignancies, hyperreactive airway diseases, pulmonary dysgenesis, and adverse reactions to treatment). This review covers the main respiratory manifestations in patients with PIDs. Key words: Primary immunodeficiency disorders. Pulmonary complications. Upper respiratory tract. Lower respiratory tract. ResumenLas inmunodeficiencias primarias (PIDs) son enfermedades causadas por uno o más defectos del sistema inmunológico. Estos pacientes presentan con frecuencia infecciones recidivantes y/o severas así como otro tipo de complicaciones. Las patologías respiratorias son la principal y más frecuente manifestación y complicación de las PIDs. Las complicaciones de estas patologías pulmonares constituyen una de las principales causas de morbimortalidad entre los pacientes que sufren PIDs. El diagnóstico temprano y el tratamiento adecuado pueden prevenir, o al menos retrasar, la aparición de las complicaciones respiratorias en estos pacientes. Dado que el espectro de las enfermedades pulmonares es muy amplio, hemos dividido estas complicaciones entre aquellas que afectan a las vías aéreas superiores (sinusitis, otitis media y angioedema laríngeo, etc.) y las que afectan a las vías aéreas bajas (neumonía, bronquitis, bronquiectasias, enfermedades pulmonares intersticiales, neumonía organizada, adenopatías pulmonares y neoplasias, hiperreactividad bronquial, disgenesia pulmonar y las debidas a los efectos secundarios del tratamiento instaurado). Este artículo revisa las manifestaciones respiratorias que se observan más frecuentemente en los pacientes con PIDs. Palabras clave: Inmunodeficiencias primarias. Complicaciones pulmonares. Vías respiratorias altas. Vías respiratorias bajas.

show abstract

“…More recently, studies have shown that higher concentrations were correlated with better clinical outcomes. 23 It is important to consider that in our study patients received doses of immunoglobulin for a few years without this individualization, maintaining IgG levels around 500 mg/dL, according to the values recommended by the literature at the time. 8 The maintenance of lower serum IgG levels may explain the development of bronchiectasis in our patients.…”

Section: Discussionmentioning

confidence: 99%

Primary hypogammaglobulinemia: The impact of early diagnosis in lung complications

Dorna

Santos

Castro

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Objective: To describe clinical features, tomographic findings and pulmonary function in pediatric patients with primary hypogammaglobulinemia (PH). Method: A retrospective cohort study of children with PH who received intravenous immunoglobulin (IVIG) and prophylactic antibiotics between 2005 and 2010. Epidemiological and clinical features, computed tomography (CT) findings, and spirometric data were compared, assuming a 5% significance level. Results:We evaluated 30 patients with PH. After the start of IVIG replacement, there was a decline in the frequency of pneumonia (p<0.001). The 11 patients with bronchiectasis in their first CT scan were older at diagnosis (p=0.001) and had greater diagnostic delay (p=0.001) compared to patients without bronchiectasis. At the end of the study, 18 patients had bronchiectasis and 27 also had other lung disorders, alone or in combination. The Bhalla score was applied to the last CT scan of 16 patients, with a median score of 11 (range 7-21), with a positive correlation between the score and the number of pneumonias after the start of treatment (r=0.561; p=0.024). The score was also correlated with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values in 13/16 patients, with negative correlation to FEV1 previously to bronchodilator (r=-0.778; p=0.002) and after bronchodilator p=0.002). Conclusion: Pulmonary complications were common in this cohort, despite the decrease in the frequency of pneumonia with treatment. Early investigation of patients with recurrent infections for primary immunodeficiencies can reduce the frequency of these complications. The monitoring of changes in spirometry may indicate the need to carry out radiological investigation.

show abstract

Impact of trough IgG on pneumonia incidence in primary immunodeficiency: A meta-analysis of clinical studies

Cited by 359 publications

References 38 publications

Subcutaneous immunoglobulin in lymphoproliferative disorders and rituximab-related secondary hypogammaglobulinemia: a single-center experience in 61 patients

Subcutaneous immunoglobulin in lymphoproliferative disorders and rituximab-related secondary hypogammaglobulinemia: a single-center experience in 61 patients

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Primary hypogammaglobulinemia: The impact of early diagnosis in lung complications

Contact Info

Product

Resources

About