title: Immunoglobulin deficiency in patients with Streptococcus pneumoniae or Haemophilus influenzae invasive infections.
abstract: OBJECTIVE
  Immunoglobulin (Ig) deficiency is a well-known risk factor for Streptococcus pneumoniae or Haemophilus influenzae infections and noteworthy invasive diseases. However, the proportion of these deficiencies in cases of invasive disease is unknown. The objective of this study was to evaluate the rate of Ig deficiency in cases of invasive disease.
  
  
  METHODS
  A prospective study was conducted from January 2008 to October 2010 in two French hospitals. Measurement of Ig levels was carried out in patients hospitalized for invasive diseases.
  
  
  RESULTS
  A total of 119 patients were enrolled in the study, with nine cases of H. influenzae and 110 cases of S. pneumoniae invasive disease. There were 18 cases of meningitis, 79 of invasive pneumonia, and 22 other invasive diseases. Forty-five patients (37.8%) had an Ig abnormality, 37 of whom had an Ig deficiency (20 IgG <6g/l, four isolated IgA <0.7g/l, and 13 isolated IgM <0.5g/l), while eight had an elevated monoclonal paraprotein. Nineteen of these 45 patients had a clearly defined Ig abnormality, with five primary deficiencies (three common variable immunodeficiencies and two complete IgA deficiencies) and 14 secondary deficiencies, mainly lymphoproliferative disorders. All these deficiencies were either not known or not substituted.
  
  
  CONCLUSIONS
  Humoral deficiency is frequent in patients with S. pneumoniae or H. influenzae invasive disease and Ig dosage should be proposed systematically after such infections.
authors: Internal Medicine and Rheumatology Department, Hôpital Civil de Colmar, 39 avenue de la Liberté, 68024 Colmar Cédex, France. Electronic address: martin.martinot@ch-colmar.fr.
authors: Martin
authors: M
authors: Martinot
authors: Infectious and Tropical Diseases Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Laetitia
authors: L
authors: Oswald
authors: Microbiology Department, Hôpital Civil de Colmar, Colmar, France.
authors: Elisabeth
authors: E
authors: Parisi
authors: Biochemistry Department, Hôpital Civil de Colmar, Colmar, France.
authors: Elodie
authors: E
authors: Etienne
authors: Infectious and Tropical Diseases Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Nicolas
authors: N
authors: Argy
authors: Microbiology Department, Hôpital Civil de Colmar, Colmar, France.
authors: Isabelle
authors: I
authors: Grawey
authors: Microbiology Department, Hôpital Civil de Colmar, Colmar, France.
authors: Dominique
authors: D
authors: De Briel
authors: Internal Medicine and Rheumatology Department, Hôpital Civil de Colmar, 39 avenue de la Liberté, 68024 Colmar Cédex, France.
authors: Mahsa Mohseni
authors: MM
authors: Zadeh
authors: Internal Medicine and Rheumatology Department, Hôpital Civil de Colmar, 39 avenue de la Liberté, 68024 Colmar Cédex, France.
authors: Laure
authors: L
authors: Federici
authors: Internal Medicine and Rheumatology Department, Hôpital Civil de Colmar, 39 avenue de la Liberté, 68024 Colmar Cédex, France.
authors: Gilles
authors: G
authors: Blaison
authors: Microbiology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Christelle
authors: C
authors: Koebel
authors: Microbiology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Benoit
authors: B
authors: Jaulhac
authors: Infectious and Tropical Diseases Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Yves
authors: Y
authors: Hansmann
authors: Infectious and Tropical Diseases Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Daniel
authors: D
authors: Christmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004406:Dysgammaglobulinemia / Q000150:complications* / Q000276:immunology; D005260:Female; D006192:Haemophilus Infections / Q000276:immunology*; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D017098:IgA Deficiency / Q000150:complications / Q000276:immunology; D017099:IgG Deficiency / Q000150:complications / Q000276:immunology; D056724:Immunity, Humoral; D007075:Immunoglobulin M / Q000172:deficiency*; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000276:immunology*; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000276:immunology*; D011446:Prospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000276:immunology; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M
keywords: Clinical study; Haemophilus influenzae; Immunoglobulin deficiency; Invasive infections; Streptococcus pneumoniae