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Screening for Antibody Deficiencies in Adults by Serum Electrophoresis and Calculated Globin

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A Correction to this article was published on 12 August 2023

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Abstract

Purpose

This study aimed to investigate the correlation between calculated globulin (CG, total protein level minus albumin level) and the gamma globulin fraction (Gamma), obtained from serum protein electrophoresis with serum IgG levels in adults (≥ 18 years).

Methods

Using linear regression models, analyses of CG and Gamma levels correlation with IgG levels in adults were performed. Receiver-operator curves were created to determine cutoff values and the respective sensitivity and specificity measures.

Results

A total of 886 samples were analyzed. CG and Gamma were positively and statistically correlated with IgG levels (r2 = 0.4628 for CG, and = 0.7941 for Gamma, p < 0.0001 for both analyses). For the detection of hypogammaglobulinemia, i.e., IgG level below the reference value (6 g/L), a CG cutoff value of 24 g/L showed a sensitivity of 86.2% (95% CI 69.4–94.5) and a specificity of 92% (90.0–93.6). A Gamma cutoff value of 7.15 g/L yielded a sensitivity of 100% (88.3–100) and a specificity of 96.8 (95.3–97.8).

Conclusion

Both CG and Gamma levels determined by protein electrophoresis analysis may be used to screen for antibody deficiencies in adults, enabling earlier diagnosis of antibody deficiencies in a routine clinical setting.

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Data Availability

All data regarding the findings are available upon request to the corresponding author.

Change history

Abbreviations

CG:

Calculated globulin

IgG:

Immunoglobulin

Gamma:

Gamma globulin

PAD:

Primary antibody deficiency

PID:

Primary immune deficiency

LFT:

Liver function test

SAD:

Secondary antibody deficiency

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Acknowledgements

We thank Dr. Mariangela Correa, Conscient Scientific Consulting, for help with manuscript writing.

Funding

This work received research grants from the Jeffrey Modell Foundation, CSL Behring and Takeda Pharma Ltda as Investigator-initiated research grant (IISR-2020–103,243).

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Authors and Affiliations

  1. Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil

    Cristina Frias Sartorelli de Toledo Piza, Carolina Sanchez Aranda & Dirceu Solé

  2. Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, Wales, UK

    Stephen Jolles

  3. Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil

    Antonio Condino-Neto

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  1. Cristina Frias Sartorelli de Toledo Piza
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  2. Carolina Sanchez Aranda
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Contributions

Study conception and design were executed by CFSTP, SJ, and ACN. Data collection was implemented by CFSTP, CSA, and DS. All authors performed data analysis, manuscript review, and final manuscript approval.

Corresponding author

Correspondence to Antonio Condino-Neto.

Ethics declarations

Ethics Approval

The University of São Paulo and Federal University of São Paulo Ethics Committees approved the protocol (approval numbers 3.340.392 and 3.499.511, respectively) according to the Brazilian Ministry of Health and the Declaration of Helsinki rules and regulations.

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Written informed consent was obtained before the inclusion of participants and blood collection.

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All authors have reviewed the final manuscript and consented to publication.

Conflict of Interest

CFSTP, CSA, DS, and ACN declare no conflict of interests. SJ has received consulting fees, speaker fees, and research grants from CSL Behring, Takeda, and Octapharma. He is a member of the UCB Pharma Data Safety and Management Board.

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de Toledo Piza, C.F.S., Aranda, C.S., Solé, D. et al. Screening for Antibody Deficiencies in Adults by Serum Electrophoresis and Calculated Globin. J Clin Immunol 43, 1873–1880 (2023). https://doi.org/10.1007/s10875-023-01536-1

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