Clinical, immunological, and molecular analysis in a large cohort of patients with X-linked agammaglobulinemia: An Italian Multicenter Study

Alessandro Plebani, Annarosa Soresina, Roberto Rondelli, Giorgio M. Amato, Chiara Azzari, Fabio Cardinale, Gianantonio Cazzola, Rita Consolini, Domenico De Mattia, Grazia Dell'Erba, Marzia Duse, Maurilia Fiorini, Silvana Martino, Baldassarre Martire, Massimo Masi, Virginia Monafo, Viviana Moschese, Luigi D. Notarangelo, Paola Orlandi, Pietro PaneiAndrea Pession, Maria C. Pietrogrande, Claudio Pignata, Isabella Quinti, Vanda Ragno, Paolo Rossi, Antonella Sciotto, Achille Stabile

Research output: Contribution to journalArticlepeer-review

Abstract

A questionnaire-based retrospective clinical and immunological survey was conducted in 73 males with a definite diagnosis of X-linked agammaglobulinemia based on BTK sequence analysis. Forty-four were sporadic and 29 familial cases. At December 2000, the patients' ages ranged from 2 to 33 years; mean age at diagnosis and mean duration of follow-up were 3.5 and 10 years respectively. After the mid-1980s all but 2 were on intravenous immunoglobulin (MG) substitution therapy, with residual IgG >500 mg/dl in 94% of the patients at the time of enrollment. Respiratory infections were the most frequent manifestation both prior to diagnosis and over follow-up. Chronic lung disease (CLD) was present in 24 patients, in 15 already at diagnosis and in 9 more by 2000. The cumulative risk to present at diagnosis with CLD increased from 0.17 to 0.40 and 0.78 when the diagnosis was made at the ages of 5, 10, and 15 years respectively. For the 9 patients who developed CLD during follow-up, the duration of follow-up, rather than age at diagnosis; previous administration of intramuscular immunoglobulin; and residual IgG levels had a significant effect on the development of CLD. Chronic sinusitis was present in 35 patients (48%), in 15 already at diagnosis and in 20 by 2000. Sistemic infections such as sepsis and meningitis/meningoencephalitis decreased over follow-up, probably due to optimal protection provided by high circulating IgG levels reached with IVIG.

Original languageEnglish
Pages (from-to)221-230
Number of pages10
JournalClinical Immunology
Volume104
Issue number3
DOIs
Publication statusPublished - Sep 2002

Keywords

  • BTK mutation
  • Infections
  • Intravenous immunoglobulin
  • X-linked agammaglobulinemia

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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