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. 2024 May 6;9(5):104.
doi: 10.3390/tropicalmed9050104.

Infectious Diseases and Secondary Antibody Deficiency in Patients from a Mesoregion of São Paulo State, Brazil

Luiz Euribel Prestes-Carneiro  1   2 , Paula Andreia Martins Carrilho  3 , Danielle Francisco Honorato de Barros Torelli  2   4 , Jose Antonio Nascimento Bressa  4 , Ana Carolina Gomes Parizi  4 , Pedro Henrique Meireles Vieira  1   2 , Fernanda Miranda Caliani Sa  4 , Mauricio Domingues Ferreira  5
Affiliations

Infectious Diseases and Secondary Antibody Deficiency in Patients from a Mesoregion of São Paulo State, Brazil

Luiz Euribel Prestes-Carneiro et al. Trop Med Infect Dis. .

Abstract

Our aim was to determine the secondary antibody deficiency (SAD) profiles of patients in a mesoregion of São Paulo state, Brazil, focusing on infectious diseases. Demographic characteristics, and clinical and laboratory data were obtained from electronic files; infections were classified as organ-specific and graded as mild, moderate, life-threatening, and fatal. Non-Hodgkin's lymphoma (NHL) accounted for 30% of patients, nephrotic syndrome (NS) 25%, chronic lymphocyte leukemia 20%, and multiple myeloma 15%. Patients with NS were younger than those in other groups, and hypo-γ-globulinemia was detected in 94.1%, IgG < 400 mg/dL in 60.0%, IgA < 40 mg/dL in 55.0%, and CD19 < 20 cells/mm3 in 30.0%. One hundred and one infections were found; 82.1% were classified as mild or moderate, 7.9% as life-threatening, and 3.0% as fatal. Respiratory tract infections were more prevalent (41.5%), and pneumonia accounted for 19.8%. Lower levels of infections were found in patients with NS compared with NHL (p = 0.0001). Most patients progressed to hypo-γ-globulinemia and SAD after treatment with immunosuppressants, and mild and moderate infections were predominant. These therapies are increasing in patients with different diseases; therefore, monitoring hypo-γ-globulinemia and infections may help to identify patients at high risk for severe complications, antibiotic prophylaxis or treatment, and immunoglobulin replacement.

Keywords: hypo-γ-globulinemia; infectious diseases; secondary antibody deficiency.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The study setting. (a) country; (b) São Paulo state; (c) Western region of São Paulo state; (d) municipality area of Presidente Prudente.
Figure 2
Figure 2
Immunologic markers in different groups of patients with secondary antibody deficiency after treatment with immunosuppressors and before replacement with immunoglobulins. NHL, non-Hodgkin’s lymphoma; NS, nephrotic syndrome; CLL, chronic lymphocytic leukemia; MM, multiple myeloma. IgG (A); IgA (B); γ-globulins (C); and CD-19 (D) levels.
Figure 2
Figure 2
Immunologic markers in different groups of patients with secondary antibody deficiency after treatment with immunosuppressors and before replacement with immunoglobulins. NHL, non-Hodgkin’s lymphoma; NS, nephrotic syndrome; CLL, chronic lymphocytic leukemia; MM, multiple myeloma. IgG (A); IgA (B); γ-globulins (C); and CD-19 (D) levels.
Figure 3
Figure 3
Distribution of infections by organs.
See this image and copyright information in PMC

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