ArticleJournal of clinical immunology2018
Prescribing Immunoglobulin Replacement Therapy for Patients with Non-classical and Secondary Antibody Deficiency: an Analysis of the Practice of Clinical Immunologists in the UK and Republic of Ireland.
Article in Journal of clinical immunology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 31 citations in OpenAlex.
- Diagnosis, Characteristics, and Outcome of Selective Anti-polysaccharide Antibody Deficiencies In A Retrospective Cohort of 55 Adult Patients.Journal of clinical immunology · 2025Observational
- Secondary antibody deficiencies in the modern era: emerging trends, diagnostic pitfalls, and advances in personalised management.Frontiers in immunology · 2025Review
- Activated phosphoinositide 3-kinase delta syndrome: Pathogenesis, clinical manifestations, and treatment.Pediatric discovery · 2024Review
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- [Prophylactic and therapeutic management of increased susceptibility to infection in patients with immunodeficiency].Der Internist · 2022Review
- Secondary Immunodeficiency and Hypogammaglobulinemia with IgG Levels of <5 g/L in Patients with Multiple Myeloma: A Retrospective Study Between 2012 and 2020 at a University Hospital in China.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- A clinician survey for management of the secondary immunodeficiency caused by hematological malignancies in China.Medicine · 2021Article
- An updated review on activated PI3 kinase delta syndrome (APDS).Genes & diseases · 2020Review
- Secondary immunodeficiencies with predominant antibody deficiency: multidisciplinary perspectives of Polish experts.Central-European journal of immunology · 2020Review
- Infection prevention in sarcoidosis: proposal for vaccination and prophylactic therapy.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2020Review
- Current clinical practice and challenges in the management of secondary immunodeficiency in hematological malignancies.European journal of haematology · 2019Article
- A Critical View of Specific Antibody Deficiencies.Frontiers in immunology · 2019Article
- A Prospective Observational Study of Hypogammaglobulinemia in the First Year After Lung Transplantation.Transplantation direct · 2018Article
- The Treatment of Activated PI3Kδ Syndrome.Frontiers in immunology · 2018Review
- Access and use of immunoglobulins in supportive cancer care: A thematic analysis of a systematic review data set.The journal of medicine accessArticle
- Polyvalent Immunoglobulin as a Potential Treatment Option for Patients with Recurrent COPD Exacerbations.International journal of chronic obstructive pulmonary diseaseReview
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Authors and funding
10 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmunologists are increasingly being asked to assess patients with non-classical and secondary antibody deficiency to determine their potential need for immunoglobulin replacement therapy (IGRT). Immunoglobulin is a limited, expensive resource and no clear guidance exists for this broad patient group. The purpose of this survey is to establish what factors influence the decision to commence IGRT in adult patients, when diagnostic criteria for primary antibody deficiency are not fulfilled.
methodsUnder the auspices of the United Kingdom Primary Immunodeficiency Network (UKPIN), a study group was established which circulated an online questionnaire to the consultant body across the UK and Ireland. Results provided a snapshot of the current clinical practice of 71% of consultant immunologists, from 30 centers.
resultsIn order of importance, factors which influence the decision to commence IGRT include number of hospital admissions with infection, serum IgG level, bronchiectasis, radiologically proven pneumonia, number of positive sputum cultures, number of antibiotic courses, and results of immunization studies. The commonest test vaccine used was Pneumovax 23 with measurement of serotype-specific responses at 4 weeks, with a threshold of 0.35 μg/ml in 2/3 of serotypes measured. Eighty-six percent of patients are treated with a trial of prophylactic antibiotics prior to consideration of IGRT. Efficacy of IGRT trial is assessed at between 6 and 12 months.
conclusionsThere was consistency in clinical practice using a combination of clinical history, evidence of infections, and vaccination testing for diagnosis. However, there was some variation in the implementation of this practice, particularly in vaccine choice and assessment of response to vaccination.
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