title: Phenotypic parameters predict time to normalization in infants with hypogammaglobulinemia.
abstract: OBJECTIVE
  Infants with recurrent infection may be found to have hypogammaglobulinemia without impaired specific antibody responses. Many will be diagnosed with transient hypogammaglobulinemia of infancy.
  
  
  METHODS
  This study used a parametric survival analysis of 100 infants with hypogammaglobulinemia to predict time to normalization.
  
  
  RESULTS
  Aggregate initial immunoglobulins (IgG + IgA + IgM), as a percentage of age-adjusted normal, predicted time to resolution: median time to resolution for the infants in the lowest quartile of aggregate levels (≤81 % of age-adjusted lower limits) was greater than 5 years, with 34 % resolving in 3 years. For infants in the highest quartile (≥130 % of age-adjusted lower limits), the median was 9.9 months, with 77 % resolving in 3 years (P = 0.008). Initial IgG level, as a percentage of age-adjusted normal, also predicted resolution: the median time in the lowest quartile (≤78 % of age-adjusted lower limits) was greater than 5 years, with 36 % resolving in 3 years. In the highest quartile (≥128 %), the median time was 14.5 months, with 70 % resolving in 3 years (P = 0.010). Male sex was associated with more rapid resolution. The median time in males was 13 months, with 73 % resolution in 3 years. The median time in females was greater than 5 years, with 32 % resolution in 3 years.
  
  
  CONCLUSIONS
  These results suggest that if a term infant presents with hypogammaglobulinemia, protective specific antibody titers, and an absence of other known immune deficiency, initial immunoglobulin levels and sex may predict time to normalization.
authors.affiliation: Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Van Winkle
authors.forename: Walter W
authors.initials: WW
authors.lastname: Hauck
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: McGeady
mesh_terms: D000361:Agammaglobulinemia / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology*; D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007136:Immunoglobulins / Q000096:biosynthesis / Q000097:blood; D016130:Immunophenotyping; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D012737:Sex Factors; D013997:Time Factors
chemical_list: D007136:Immunoglobulins