Secondary hypogammaglobulinemia: diagnosis and management of a pediatric condition of clinical importance

Author:

DiGiacomo Daniel12,Barmettler Sara34

Affiliation:

1. Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune

2. Hackensack Meridian School of Medicine, Nutley, New Jersey

3. Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital

4. Harvard Medical School, Boston, Massachusetts, USA

Abstract

Purpose of review Secondary hypogammaglobulinemia, or low serum immunoglobulins, is associated with a variety of medications or medical conditions and may be symptomatic and lead to increased infectious risk. There is limited data regarding the study of acquired, or secondary, hypogammaglobulinemia (SHG) in pediatrics. The data to date has suffered from methodologic issues including retrospective study design, lack of baseline immunoglobulin measurements, and limited longitudinal follow-up. Recent findings There is emerging research on the impact of B-cell depleting therapies, specifically rituximab and chimeric antigen T-cells, along with other autoimmune and malignant disease states, in the development of SHG in pediatric patients. This review will also summarize other relevant pediatric conditions related to SHG. Summary The clinical relevance of SHG in pediatrics is increasingly appreciated. Improved understanding of the specific etiologies, risk factors, and natural history of SHG have informed screening and management recommendations.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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