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Clinical Trial
. 2021 Aug 23:12:712637.
doi: 10.3389/fimmu.2021.712637. eCollection 2021.

Serum Protein Electrophoresis May Be Used as a Screening Tool for Antibody Deficiency in Children and Adolescents

Cristina Frias Sartorelli de Toledo Piza  1 , Carolina Sanchez Aranda  2 , Dirceu Solé  2 , Stephen Jolles  3 , Antonio Condino-Neto  4
Affiliations
Clinical Trial

Serum Protein Electrophoresis May Be Used as a Screening Tool for Antibody Deficiency in Children and Adolescents

Cristina Frias Sartorelli de Toledo Piza et al. Front Immunol. .

Abstract

Background: Patients with antibody deficiency may experience exceptionally long diagnostic delays, increasing the risk of life-threatening infections, end-organ damage, mortality, and health costs.

Objective: This study aimed to analyze serum protein electrophoresis and verify the correlation between calculated globulin (CG, total protein minus albumin levels) or electrophoretically determined serum gamma globulin fraction (Gamma) with IgG levels in children and adolescents under 18 years old (yo).

Methods: We analyzed serum protein electrophoresis (GC or Gamma) and IgG levels from 1215 children and adolescents under 18 yo, classified into 5 age groups. We verified the correlation between CG or Gamma with serum IgG levels.

Results: Serum IgG levels varied according to age groups (from 4.3 ± 2.3 g/l in children under 6 months old to 11.4 ± 3.2 g/l in adolescents in the 10-<18 yo group). CG sensitivity and specificity to detect IgG below the reference range for all patients were 93.1% and 81.8%, respectively, and varied according to age group. Gamma sensitivity and specificity for all patients were 100% and 87.8%, respectively, and varied according to age group as well. We found serum IgG levels below the age reference level in 29 patients (2.4% of the cases) using CG or Gamma levels.

Conclusion: Both CG and Gamma levels may be of utility as a screening tool for earlier diagnosis of antibody deficiency in children and adolescents under 18 yo.

Keywords: antibody deficiency; calculated globulin (CG); children; gamma globulin fraction; immunoglobulin G (IgG); serum protein electrophoresis (SEP).

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Conflict of interest statement

AC-N declare receiving speaker’s fees and participating in advisory boards for Takeda, CSL Behring, Novartis, AstraZeneca, GSK, and Sanofi Genzyme. SJ has participated in advisory boards, trials, conferences, projects, and has been a speaker with CSL Behring, Takeda, Swedish Orphan Biovitrum, Biotest, Binding Site, Grifols, BPL, Octapharma, LFB, Pharming, GSK, Weatherden, Zarodex, Sanofi, and UCB Pharma. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Sample flow. *CG – Calculated Globulin. **Gamma – Gamma Globulin fraction.
Figure 2
Figure 2
Correlation between IgG (g/L) and Calculated Globulin values (g/L) according to age groups. (A) 1 to 5 months. (B) 6 to 11 months. (C) 1 to 3 years. (D) 4 to 9 years. (E) 10 to <18 years. (F) All age groups combined.
Figure 3
Figure 3
Correlation between IgG (g/L) and Gamma globulin values (g/L) according to age groups. (A) 1 to 5 months. (B) 6 to 11 months. (C) 1 to 3 years. (D) 4 to 9 years. (E) 10 to <18 years. (F) All age groups combined.
See this image and copyright information in PMC

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