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Transient Hypogammaglobulinemia of Infancy

By James Fernandez, MD, PhD, Clinical Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University; Director, Allergy and Clinical Immunology, Louis Stokes VA Medical Center, Wade Park; Cleveland Clinic, Staff, Department of Allergy and Clinical Immunology,

In transient hypogammaglobulinemia of infancy, production of normal amounts of antibodies (immunoglobulins) in infants is delayed.

At birth, the immune system is not fully developed. Most of the immunoglobulins in infants are those produced by the mother and transferred via the placenta before birth. Immunoglobulins from the mother protect infants against infection until infants start to produce their own, usually by age 6 months. About the same time, levels of immunoglobulins from the mother start to decrease.

In infants with transient hypogammaglobulinemia of infancy, production of normal amounts of immunoglobulins is delayed. As a result, immunoglobulin levels become low starting at age 3 to 6 months and return to normal at about age 12 to 36 months.

Transient hypogammaglobulinemia of infancy rarely leads to serious infections and is not thought to be a true immunodeficiency. However, a few infants develop frequent sinus, lung, or digestive tract infections, candidiasis (a fungal infection), and/or meningitis.

This condition is more common among premature infants because they receive fewer immunoglobulins from the mother.

Blood tests are done to measure levels of immunoglobulins and to evaluate immunoglobulin production in response to vaccines. Usually, infants with the disorder produce normal amounts of antibodies in response to the vaccines they are given and to infectious organisms they are exposed to. However, if infants, particularly those born prematurely, have frequent infections, they may be given antibiotics to prevent more infections from developing.

This disorder may last for months to a few years but usually resolves without treatment.