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Lookup NU author(s): Dr Alex Battersby, Dr Ben ShillitoeORCiD, Dr Terence Flood, Professor Andrew Cant, Dr Catherine Stroud, Professor Andrew GenneryORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Patients with congenital agammaglobulinemia, characterized by a defect in B lymphocyte differentiation causing B alymphocytosis, require life-long IgG replacement. There is scant literature regarding the effectiveness of IgG treatment at preventing mucosal (particularly sinopulmonary tract) infection and whether current management adequately restores "normal" health and quality of life (QoL). We aimed to document infective episodes pre- and post-commencing IgG replacement, determine any change in lung function and structure and assess respiratory status and QoL in a cohort of patients treated in Newcastle.Clinical data were extracted from medical records of 15 patients identified from the immunology database, focusing on infective episodes, serial chest CT and spirometry results. Thirteen patients completed a selection of standardized and validated questionnaires assessing physical health, respiratory health and QoL.Pediatric patients on IgG therapy suffered fewer infections per patient year (0.74) than adults (2.13). 6/14 patients showed deteriorating respiratory status despite adequate therapy. Health questionnaires revealed a significant burden of respiratory disease on a patient's life.Clinical data showed patients with congenital agammaglobulinemia receiving immunoglobulin therapy retained a higher than average infection rate, most of which affected mucosal barriers. Most patients self-reported worse respiratory symptoms, a lower respiratory-related QoL and a lower general health QoL relative to a healthy population. Most participants had progressive structural lung damage and decreased lung function. These results suggest that current management is not entirely effective at preventing deterioration of respiratory health or restoring QoL.
Author(s): Bryan BA, Battersby A, Shillitoe BMJ, Barge D, Bourne H, Flood T, Cant AJ, Stroud C, Gennery AR
Publication type: Article
Publication status: Published
Journal: Journal of Clinical Immunology
Year: 2016
Volume: 36
Issue: 5
Pages: 472-479
Print publication date: 01/07/2016
Online publication date: 18/04/2016
Acceptance date: 05/04/2016
Date deposited: 28/07/2016
ISSN (print): 0271-9142
ISSN (electronic): 1573-2592
Publisher: Springer
URL: http://dx.doi.org/10.1007/s10875-016-0284-3
DOI: 10.1007/s10875-016-0284-3
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