European Journal of Pediatrics

, Volume 150, Issue 4, pp 234–237 | Cite as

IgG2 deficiency in children with human immunodeficiency virus infection

  • P. Bartmann
  • I. Grosch-Wörner
  • V. Wahn
  • B. H. Belohradsky


Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Despite elevated serum immunoglobulin levels, a significant deterioration of the antigen specific humoral immune response exists in most cases. We studied the influence of HIV infection on the serum levels of IgG subclasses in children. We investigated 76 children (aged 15 months to 18 years) with HIV-1-infection. Most children (88%) showed elevated serum immunoglobulin levels. IgA (87%) and IgM (74%) were more often above normal levels for age than IgG (60%). IgG subclass serum levels were significantly altered. The increase in total IgG was mainly due to a marked augmentation of the IgG1 fraction. In most cases IgG3 was simultaneously elevated. Ten children (13%) had very low IgG4 levels (<0.03 g/l). Out of 61 patients older than 2 years 8 (13%) had a profound IgG2 deficiency with normal or elevated total IgG. Four of them also had low IgG4 levels (<0.03 g/l). A correlation between IgG2 deficiency and HIV infection according to the Centres for Disease Control classification for acquired immunodeficiency syndrome could not be demonstrated (three patients with symptomatic and five with asymptomatic infection).

Key words

HIV infection AIDS IgG subclass deficiency 



acquired immunodeficiency syndrome


human immunodeficiency virus


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  1. 1.
    Aucouturier P, Couderc LJ, Gonet D, Danon F, Gombert J, Matheron S, Saimot AG, Claucel JP, Preud'homme IL (1986) Serum immunoglobulin G subclass dysbalances in the lymphadenopathy syndrome and acquired immune deficiency syndrome. Clin Exp Immunol 63:234–240PubMedGoogle Scholar
  2. 2.
    Barbour SD (1987) Acquired immunodeficiency syndrome of childhood. Pediatr Clin North Am 34:247–268PubMedGoogle Scholar
  3. 3.
    Bartmann P, Kleihauer E (1988) Undetectable IgG4 in immunoprecipitation: association with repeated infections in children? Eur J Pediatr 148:211–214PubMedGoogle Scholar
  4. 4.
    Beard LJ, Ferrante A, Oxelius VA, Maxwell GM (1986) IgG subclass deficiency presenting with recurrent severe respiratory infections. Pediatr Res 20:937–942PubMedGoogle Scholar
  5. 5.
    Beck CS, Heiner DC (1981) Selective immunoglobulin G4 deficiency and recurrent infections of the respiratory tract. Am Rev Respir Dis 124:94–96PubMedGoogle Scholar
  6. 6.
    Bernstein LJ, Ochs HD, Wedgwood RJ, Rubinstein A (1986) Defective humoral immunity in pediatric acquired immunodeficiency syndrome. J Pediatr 10:352–357Google Scholar
  7. 7.
    Borkowsky W, Steele CJ, Grubman S, Moore T, La Russa P, Krasinski K (1987) Antibody responses to bacterial toxoids in children infected with human immunodeficiency virus. J Pediatr 110:563–566PubMedGoogle Scholar
  8. 8.
    Brückmann C, Rosendahl C, Neumann J, Wintergerst U, Gandenberger S, Anberger K, Belohradsky BH (1988) Pediatric HIV infections: a review. AIFO 651–670Google Scholar
  9. 9.
    Centers for Disease Control (1987) Classification system for human immunodeficiency virus (HIV) infection in children under 13 xears of age. MMWR 36:225–236Google Scholar
  10. 10.
    Church JA, Lewis J, Spotkov JM (1984) IgG subclass deficiencies in children with suspected AIDS. Lancet I:279Google Scholar
  11. 11.
    Giessen M van der, Rossouw E, Algra-van Veen T, Loghem E van, Zegers BJM, Sander PD (1975) Quantification of IgG subclasses in sera of normal adults and healthy children between 4 and 12 years of age. Clin Exp Immunol 21:501–509Google Scholar
  12. 12.
    Heiner DC (1984) Significance of immunoglobulin G subclasses. Am J Med 76:1–6Google Scholar
  13. 13.
    Heiner DC, Myers A, Beck CS (1983) Deficiency of IgG4: a disorder associated with frequent infections and bronchiectasis that may be familial. Clin Rev Allerg 1:259–266Google Scholar
  14. 14.
    Honda NS, Sun NCJ, Heiner DC (1987) Isolated IgG4 subclass deficiency and malignant lymphoma in a child with acquired immunodeficiency syndrome. Am J Dis Child 141:398–399PubMedGoogle Scholar
  15. 15.
    Lane HC, Masur H, Edgar LC, Whalen G, Rook AH, Fauci AS (1983) Abnormalities of B cell activation and immunog-lobulinregulation in patients with acquired immunodeficiency syndrome. N Engl J Med 309:453–458PubMedGoogle Scholar
  16. 16.
    Morell A, Skvaril F, Hitzig WH, Barandun S (1972) IgG subclasses: development of the serum concentrations in “normal” infants and children. J Pediatr 80:960–964PubMedGoogle Scholar
  17. 17.
    Morell A, Skvaril F, Barandun S (1975) IgG Subklassen der menschlichen Immunoglobuline. Karger, BaselGoogle Scholar
  18. 18.
    Ouchterlony O (1958) Diffusion-in-gel methods for immunological analysis. Prog Allergy 5:1PubMedGoogle Scholar
  19. 19.
    Oxelius VA (1979) IgG subclass levels in infancy and childhood. Acta Paediatr Scand 68:23–27PubMedGoogle Scholar
  20. 20.
    Oxelius VA (1984) Immunoglobulin G (IgG) subclasses and human disease. Am J Med 76:7–18PubMedGoogle Scholar
  21. 21.
    Papadea C, Check IJ, Reimer CB (1985) Monoclonal antibody based solid-phase immunoenzymometric assays for quantifying human immunoglobulin G and its subclasses in serum. Clin Chem 31:1940–1945PubMedGoogle Scholar
  22. 22.
    Rubinstein A (1986) Pediatrics AIDS. CPP:361–409Google Scholar
  23. 23.
    Rubinstein A, Sicklick M, Gupta A, Bernstein L, Klein N, Rubinstein E, Spigland J, Fruchter L, Litman N, Lee H, Hollander M (1983) Aquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers. JAMA 249:2350–2356PubMedGoogle Scholar
  24. 24.
    Schur PH, Rosen F, Norman ME (1979) Immunoglobulin subclasses in normal children. Pediatr Res 13:181–183PubMedGoogle Scholar
  25. 25.
    Shackelford PG, Polmar SH, Mayus JL, Johnston WL, Corry JM, Nahm MH (1986) Spectrum of IgG2 subclass deficiency in children with recurrent infections: prospective study. J Pediatr 108:647–653PubMedGoogle Scholar
  26. 26.
    Stanley PJ, Corbo G, Cole PJ (1984) Serum IgG subclass in chronic and recurrent respiratory infections. Clin Exp Immunol 58:703–708PubMedGoogle Scholar
  27. 27.
    Stiehm ER, Fudenberg HH (1966) Serum levels of immunoglobulins in health and disease: a survey. Pediatrics 37:715–727PubMedGoogle Scholar
  28. 28.
    White MV, Haddad A, Bellanti JA (1985) Selective IgG2 deficiency in a patient with skin and upper respiratory tract infection. Ann Allergy 54:498–501PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • P. Bartmann
    • 1
  • I. Grosch-Wörner
    • 2
  • V. Wahn
    • 3
  • B. H. Belohradsky
    • 4
  1. 1.Children's Hospital, Department IIUniversity of UlmUlmFederal Republic of Germany
  2. 2.Children's HospitalUniversity of BerlinBerlinFederal Republic of Germany
  3. 3.Children's HospitalUniversity of DüsseldorfDüsseldorfFederal Republic of Germany
  4. 4.Children's HospitalUniversity of MunichMünchenFederal Republic of Germany

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