eMedicine Specialties > Pediatrics: General Medicine > Allergy & Immunology

Transient Hypogammaglobulinemia of Infancy: Follow-up

Author: Alan P Knutsen, MD, Professor of Pediatrics, Allergy and Immunology, Director of Pediatric Clinical Immunology Laboratory, Department of Pathology, St Louis University Health Sciences Center
Contributor Information and Disclosures

Updated: Jun 20, 2008

Follow-up

Further Outpatient Care

  • Confirm initial diagnosis by measuring serum immunoglobulin levels annually until levels normalize.
  • As discussed above, treatment of infections and modalities to reduce infections should be instituted. Treatment of allergic disorders should also be instituted.
  • With appropriate treatment, these children can be considered healthy. The prognosis for transient hypogammaglobulinemia of infancy (THI) is quite good. Most children outgrow this immune deficiency when aged 2-6 years. However, THI is a diagnosis that is made retrospectively when serum immunoglobulin levels normalize and all antibody responses are normal.
  • The immune system is periodically evaluated, usually at yearly intervals.

Prognosis

  • Long-term prognosis for patients with THI is excellent; the immune system becomes normal in patients by age 2-6 years.
  • Serious life-threatening infections in patients with THI are rare.

Patient Education

  • Inform parents that THI is an immunodeficiency that eventually self-corrects because it is a maturational immunodeficiency.
  • Also inform parents that patients are unlikely to have serious life-threatening infections.
  • In addition, many infants with THI have or develop concomitant allergic diseases.

Miscellaneous

Medicolegal Pitfalls

  • Failure to differentiate transient hypogammaglobulinemia of infancy (THI) from other, more severe, forms of B-cell immunodeficiency such as Bruton agammaglobulinemia, common variable immunodeficiency, and HIGM has serious consequences because patients with more severe B-cell defects are susceptible to serious life-threatening bacterial infections that require IVIG therapy.
 


More on Transient Hypogammaglobulinemia of Infancy

Overview: Transient Hypogammaglobulinemia of Infancy
Differential Diagnoses & Workup: Transient Hypogammaglobulinemia of Infancy
Treatment & Medication: Transient Hypogammaglobulinemia of Infancy
Follow-up: Transient Hypogammaglobulinemia of Infancy
References
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References

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Further Reading

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Keywords

transient hypogammaglobulinemia of infancy, THI, decreased immunoglobulin A, IgA, decreased immunoglobulin G, IgG, immunoglobulin M, IgM, common variable immunodeficiency, CVID, Bruton's agammaglobulinemia, hyper-IgM syndrome, HIGM, B-cell defect, dysgammaglobulinemia, upper respiratory tract infections, otitis media, sinusitis, pneumonia, severe combined immunodeficiency, SCID, bronchial infections, polysaccharide-encapsulated bacteria, varicella, oral candidiasis, sepsis, meningitis, food allergy, asthma, allergic rhinitis, acute lymphocytic leukemia, ALL, X-linked infantile agammaglobulinemia

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Contributor Information and Disclosures

Author

Alan P Knutsen, MD, Professor of Pediatrics, Allergy and Immunology, Director of Pediatric Clinical Immunology Laboratory, Department of Pathology, St Louis University Health Sciences Center
Alan P Knutsen, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology and Clinical Immunology Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

David J Valacer, MD, Consulting Staff, Hoffman La Roche Pharmaceuticals
David J Valacer, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association for the Advancement of Science, American Thoracic Society, and New York Academy of Sciences
Disclosure: Nothing to disclose.

CME Editor

David Pallares, MD, Clinical Assistant Professor, Department of Pediatrics, Division of Allergy and Immunology, University of Louisville
David Pallares, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology
Disclosure: Nothing to disclose.

Chief Editor

Harumi Jyonouchi, MD, Associate Professor, Department of Pediatrics, Division of Pulmonary Allergy/Immunology and Infectious Diseases, UMDNJ-New Jersey Medical School
Harumi Jyonouchi, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association of Immunologists, American Medical Association, Clinical Immunology Society, New York Academy of Sciences, Society for Experimental Biology and Medicine, Society for Mucosal Immunology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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