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Agammaglobulinemia

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Contents of this page:

Illustrations

Antibodies
Antibodies

Alternative Names    Return to top

Bruton's agammaglobulinemia; X-linked agammaglobulinemia

Definition    Return to top

Agammaglobulinemia is an inherited disorder in which there are very low levels of protective immune proteins called immunoglobulins. People with this disorder develop repeated infections.

Causes    Return to top

Agammaglobulinemia is rare disorder that mainly affects males. It is the result of a genetic abnormality that blocks the development of normal, mature immune cells called B-lymphocytes.

As a result, the body produces very little (if any) immunoglobulins in the bloodstream. Immunoglobulins play a major role in the immune response, which protects against illness and infection.

Without protective immunoglobulins, people with agammaglobulinemia develop repeated infections. People with this disorder are particularly susceptible to bacterial infections caused by Haemophilus influenzae, pneumococcus (Streptococcus pneumoniae), and staphylococci, as well as to repeated viral infections. Common sites of infection include:

Symptoms    Return to top

The person may have a family history of agammaglobulinemia (or other immune disorder).

Symptoms include frequent episodes of:

Infections typically appear in the first 4 years of life.

Exams and Tests    Return to top

The disorder is confirmed by laboratory measurement of blood immunoglobulins. Tests include:

Treatment    Return to top

The goal of treatment is to reduce the number and severity of infections as well as to provide genetic counseling to affected families.

Intravenous infusions of immunoglobulins (IVIG) help boost the immune system by providing the body with the antibodies that are decreased or missing. Routine treatment with IVIG is central to the treatment of this disorder.

Antibiotics are frequently necessary for the treatment of bacterial infections.

Outlook (Prognosis)    Return to top

Treatment with immune globulins has improved the health of people with agammaglobulinemia. Without treatment, most severe infections are fatal.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if you or your child has experienced frequent infections.

Call for an appointment with your health care provider if you have a family history of agammaglobulinemia or other immunodeficiency disorder and you are planning to have children -- ask the provider about genetic counseling.

Prevention    Return to top

Genetic counseling may be offered to prospective parents with a family history of agammaglobulinemia or other immunodeficiency disorders.

References    Return to top

Azar AE. Evaluation of the adult with suspected immunodificiency. Am J Med. 2007;120(9):764-8.

Bonilla FA. Update on primary immunodeficiency diseases. J Allergy Clin Immunol. 2006;117(2 Suppl Mini-Primer):S435-41.

Morimoto Y. Immunodeficiency overview. Prim Care. 2008;35(1):159-73,viii.

Update Date: 5/6/2008

Updated by: Stuart I. Henochowicz, MD, FACP, Associate CLinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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