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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Primary Immunodeficiencies
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1495564
This article is part of the Research Topic Community Series in Primary Immunodeficiencies Worldwide: Volume II View all 8 articles

Calculated globulin can be used as a screening test for antibody deficiency in children and adolescents

Provisionally accepted
Cristina Frias Sartorelli Toledo Piza Cristina Frias Sartorelli Toledo Piza 1Carolina S. Aranda Carolina S. Aranda 1DIRCEU SOLE DIRCEU SOLE 1Stephen Jolles Stephen Jolles 2Antonio Condino-Neto Antonio Condino-Neto 3*
  • 1 Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), Divison of Allergy, Immunology and Rheumatology, Department of Pediatrics, UNIFESP, São Paulo, Brazil
  • 2 Immunodeficiency Centre for Wales, Department of Immunology, University Hospital of Wales, Cardiff, United Kingdom
  • 3 Immunology, University of São Paulo, São Paulo, SP, Brazil

The final, formatted version of the article will be published soon.

    Purpose -Calculated globulin (CG, total protein minus albumin levels) correlate well with IgG levels and has been proposed as a suitable screening method for individuals with primary antibody deficiencies (PADs). We aimed to show the correlation of CG with IgG levels in children and adolescents, utilizing a common method for albumin measurement, bromocresol green.Methods -Individuals from two Allergy and Immunology clinics were invited to participate.Inclusion criteria were age < 18, stable conditions, and signed informed consent. We included 1084 individuals. Immunoglobulin G values were determined by immunoturbidimetry; the colorimetric bromocresol green method and the Architect Biuret method were utilized for the albumin and total protein (TP) measurements, respectively.Results -A total of 1084 individuals were included in the analysis and divided into 4 age groups (0 to <1 year, 1 to <4 years, 4 to <10 years, and 10 to <18 years). For all patients, the mean age was 6.1 (±5) years old, the mean IgG was 9.4 (±4.7) g/L, and CG was 23.7 (±5.9) g/L. The most frequent diagnosis were respiratory allergies, followed by inborn errors of immunity. IgG and CG varied according to age group. Cutoff values for hypogammaglobulinemia varied from 13.8 g/L in children < 1 year to 23.1 g/L in children and adolescentsaged 10 to <18 years. CG sensitivity varied from 70.9% in children aged 1 to <4 years old to 95.8% in children 4 to <10. Specificity ranged from 87.5% in children 4 to <10 years old to 100% in children and adolescents aged 10 to <18 years. Conclusion -CG is a suitable screening test for hypogammaglobulinemia in children less than 18 years of age.

    Keywords: Antibody deficiency, hypogammaglobulinemia, Primary immunodeficiency, secondary immunodeficiency, calculated globulin (CG)

    Received: 12 Sep 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Frias Sartorelli Toledo Piza, Aranda, SOLE, Jolles and Condino-Neto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Antonio Condino-Neto, Immunology, University of São Paulo, São Paulo, 05508-000, SP, Brazil

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