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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Primary Immunodeficiencies
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1552513
Reappraisal of IgG subclass deficiencies; a retrospective comparative cohort study
Provisionally accepted
Damla Dogru 1
Yagmur Dogru 1
Faranaz Atschekzei 1,2
Abdulwahab Elsayed 1,2
Natalia Dubrowinskaja 1,2
Diana Ernst 1
Torsten Witte 1,2
Vega Gödecke 3,4
Georgios Sogkas 1,2*- 1 Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany, Hannover, Germany
- 2 Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
- 3 Center for Rare Diseases, Hannover Medical School, Hannover, Germany, Hannover, Germany
- 4 Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany, Hannover, Germany
The aim of the present study was to investigate the clinical spectrum of IgG subclass deficiencies (IgGSDs) and assess the relative clinical significance of diagnosing each specific IgGSD disorder as compared to the common variable immunodeficiency (CVID).We retrospectively evaluated the clinical spectrum and immunological finding s from 96 patients, diagnosed with diverse IgGSDs. Specific IgGSDs were compared with each other and a cohort of 270 patients with CVID.In comparison to CVID, recurrent lower respiratory tract infections (LRTI) and bronchiectasis were rarer in IgGSDs, while recurrent mucocutaneous herpes simplex virus reactivations were more common. With respect Dogru et al.to autoimmunity, IgGSDs associated with arthritis, while autoimmune cytopenias were less freque ntly observed than in CVID. Among IgGSDs, herpes zoster was more common in IgG3SD. Arthritis was more prevalent in IgG1+3SD. Given its association with LRTI, splenomegaly and immune thrombocytopenic purpura and the relatively lower class-switch memory B cell counts, IgG2+4SD is the IgGSD which rather resembles CVID.Comparative evaluation of phenotypes and treatments of patients with IgGSDs and CVID reveals distinct features, suggesting the differential clinical significance of diagnosing IgGSDs. The differential clinical expressions of IgGSDs highlights the need for studying each IgGSD separately, in order to optimize disorderspecific follow-up procedures and prophylactic anti-infective measures.
Keywords: Common variable immunodeficiency, IgG subclasses, IgG subclass deficiency, predominantly antibody deficiencies, bronchiectasis, arthritis, herpes zoster Abbreviations: CVID, common variable immunodeficiency, IgGSD, IgG subclass deficiency, PAD, predominantly antibody deficiency, Bronchiectasis, Varizella zoster virus, Herpes Simplex (HSV)
Received: 28 Dec 2024; Accepted: 01 Apr 2025.
Copyright: © 2025 Dogru, Dogru, Atschekzei, Elsayed, Dubrowinskaja, Ernst, Witte, Gödecke and Sogkas. 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:
Georgios Sogkas, Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany, Hannover, Germany
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