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Abstract
Specific antibody deficiency (SAD) is characterized by a poor response to polysaccharide antigens and post-PPV23 anti-pneumococcal antibodies must be evaluated for its diagnosis. When this study was proposed, the diagnostic method for SAD was not available in Paraguay and there is no data on this deficiency in our country.
Objective: To evaluate the presence of SAD and other antibody deficiencies by studying the anti-pneumococcal response and serum immunoglobulins in pediatric patients with recurrent infections.
Patients and Method: 50 patients aged 2 to 17 years were included, who attended pediatric services at two public hospitals in Paraguay, between 2019 and 2022. Pre- and post-PPV23 serum anti-pneumococcal antibodies were measured by a global ELISA assay, as well as serum immunoglobulins IgA, IgG, and IgM by radial immunodiffusion, and IgG subclasses by automated method.
Results: The median age was 5 years (IQR: 3-8), with a slight predominance of males (52.0%). Upper (70.0%) and lower (62.0%) respiratory infections and allergies (76.0%) were frequent. Anti-pneumococcal antibodies increased significantly (p < 0.001) post-PPV23, however, two patients (4.0%) presented poor anti-pneumococcal response and were defined as SAD cases. In addition, 5 isolated IgG deficiencies, 2 IgA deficiencies (DIgA), 2 DIgA-associated subclass deficiencies, and a common variable immunodeficiency were detected.
Conclusions: We provide the first data on the specific antibody deficiency and implement the diagnostic technique in our country. It is necessary to continue strengthening knowledge about these pathologies among local pediatricians to improve clinical suspicion, diagnosis, and treatment.
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