반복적인 호흡기 감염과 천식 악화가 동반된 IgG3 아형결핍증 성인 환자에서 intravenous immunoglobulin 사용 1예
Intravenous immunoglobulin therapy in a selective IgG3 defi cient patient with recurrent respiratory infections and asthma att acks
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초록
The IgG subclass defi ciency is defi ned as a signifi cant decrease in the serum concentrations of one or more subclasses of IgG in a patient whose total IgG concentration is normal. IgG subclass defi ciency can predispose to recurrent sinopulmonary infections. A 29-year-old female patient with a 4-year history of bronchial asthma presented with cough, sputum, dyspnea, and recurrent respira- tory infections. She had frequently been treated with antibiotics and systemic steroids for recurrent respiratory infections and acute asthma exacerbations. Chest X-ray and computed tomography showed pectus excavatum and bronchial wall thickening without lung parenchymal abnormalities. On immunological evaluation, she was found to have a low serum IgG3, with normal total IgG concentration. Under diagnosis of selective IgG3 defi ciency, she was started on monthly infusions of intravenous immunoglobulin (IVIG) therapy. The frequency and severity of respiratory infections and acute asthma exacerbations were markedly decreased dur- ing 3 years of IVIG therapy. Our case report suggests that a patient who has underlying selective IgG3 defi ciency and asthma may benefi t from IVIG therapy as this can signifi cantly reduce the incidence and severity of recurrent respiratory infections and acute asthma exacerbations.
Abstract
The IgG subclass defi ciency is defi ned as a signifi cant decrease in the serum concentrations of one or more subclasses of IgG in a patient whose total IgG concentration is normal. IgG subclass defi ciency can predispose to recurrent sinopulmonary infections. A 29-year-old female patient with a 4-year history of bronchial asthma presented with cough, sputum, dyspnea, and recurrent respira- tory infections. She had frequently been treated with antibiotics and systemic steroids for recurrent respiratory infections and acute asthma exacerbations. Chest X-ray and computed tomography showed pectus excavatum and bronchial wall thickening without lung parenchymal abnormalities. On immunological evaluation, she was found to have a low serum IgG3, with normal total IgG concentration. Under diagnosis of selective IgG3 defi ciency, she was started on monthly infusions of intravenous immunoglobulin (IVIG) therapy. The frequency and severity of respiratory infections and acute asthma exacerbations were markedly decreased dur- ing 3 years of IVIG therapy. Our case report suggests that a patient who has underlying selective IgG3 defi ciency and asthma may benefi t from IVIG therapy as this can signifi cantly reduce the incidence and severity of recurrent respiratory infections and acute asthma exacerbations.
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