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An immunoglobulin deficiency is a medical condition characterized by low levels of immunoglobulin. There are a number of immunoglobulins in the body, with A, D, E, G, and M immunoglobulins being among the most common and most important. When people do not have adequate supplies of immunoglobulins, they are less able to fight off disease and can be prone to getting sick. They may also be more vulnerable to infections that individuals with healthy immune systems could easily fight off.
The immunoglobulins are part of the body's humoral immunity. They are produced by B lymphocytes and are capable of carrying antibodies that will bind to antigens. Antibodies can neutralize antigens by preventing them from binding with cells in the body and they can also act to tag infectious material so it can be destroyed by the immune system. People lacking immunoglobulins have less effective humoral immunity, although their cellular immunity remains intact.
Some cases of immunoglobulin deficiency are inherited. There are a number of genetic conditions involving B lymphocytes that can limit the number of immunoglobulins produced. Other patients have an acquired immunoglobulin deficiency, which may be secondary or primary. Primary deficiencies are caused by diseases that directly impact the B cells, while secondary deficiencies emerge as part of an overall disease process.
Patients can be diagnosed with an immunoglobulin deficiency with a blood test to count levels of immunoglobulins in the blood. Some patients are symptomatic and may only be diagnosed during the course of routine bloodwork, such as the screening of blood donations performed at blood banks. Other patients have clear immune problems that lead to a workup, during which the low levels of immunoglobulins in the blood will be noted.
Immunoglobulin deficiency treatments vary, depending on the cause. In a secondary deficiency, treating the underlying disease should resolve the problem. With primary deficiencies, treating the condition that is damaging the B cells may raise immunoglobulin levels. Treatments can include bone marrow transplants, as well as injections of immune serum that introduce donor immunoglobulin to the patient's body.
As long as immunoglobulin levels remain low, patients are an increased risk for getting sick. Patients are usually advised to exercise precautions, including avoiding environments where people are sick with contagious diseases. The deficiency will also be noted in the patient's chart so that care providers are aware of the patient's circumstances and know to take additional precautions with that patient.
My roommate has selective immunoglobulin IgA deficiency, and if she gets sick, she usually gets the worst that the sickness has to offer. Her immune system is very weak, so once she gets infected with something, it takes her a long time to shake it off.
She once got a sinus infection that led to acute asthma. Everyone with a sinus infection has trouble breathing, and some develop a chest cough, but hers was intense.
She got an ear infection that wound up causing temporary hearing loss. In people with her condition, antibiotics don’t work so well.
Children with immunoglobulin deficiencies can have a hard time making friends. My niece cannot attend school because of her deficiency. Her risk of getting sick would be too great.
Before any children come over to play, her mother has to talk with their parents and make sure that they haven’t recently been sick. She is not allowed to touch anyone, and she most definitely cannot share drinks or food.
When her mother takes her shopping, she goes with her into the public restrooms to open doors and turn knobs for her. She doesn’t want her to touch any germs.
I don’t know what she is going to do when she grows up. Hopefully, her doctor will find a way to resolve the deficiency.