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Recommendation 4.4
➤ We recommend the diagnosis of selective IgA deficiency (SIGAD) for
patients older than 4 years of age with serum IgA level below the limit
of detection and normal serum IgG and IgM levels. (S-H)
Recommendation 4.5
➤ We suggest the diagnosis of IgG subclass deficiency for patients with
recurrent infections and low levels of 1 or more serum IgG subclass
levels (IgG1, IgG2, or IgG3 excluding IgG4) and normal serum total
IgG levels. (C-M)
Recommendation 4.6
➤ We suggest the diagnosis of specific antibody deficiency (SAD) to
polysaccharides for patients with recurrent respiratory infections and
impaired antibody responses to polysaccharides and normal serum
total IgG levels. (C-M)
Recommendation 4.7
➤ We suggest the diagnosis of SAD to protein antigen for patients with
recurrent infections and impaired antibody responses to protein
antigen immunizations and normal serum total IgG levels. (C-L)
Recommendation 4.8
➤ We recommend that patients with low serum IgG and IgA levels
and normal or elevated serum IgM level be given the diagnosis of
immunoglobulin class-switch defects after ruling out combined
immunodeficiencies that present with similar laboratory findings. (S-H)
Recommendation 4.9
➤ We recommend the diagnosis of transient hypogammaglobulinemia
of infancy (THI) for infants and children with low serum IgG level and
normal antibody response to immunizations and absent evidence of
secondary causes. (S-H)
Recommendation 4.10
➤ We suggest the diagnosis of unspecified primary
hypogammaglobulinemia for patients with recurrent infections and low
serum IgG level and normal cellular immunity and absent evidence of
secondary causes of low IgG levels and not fulfilling diagnostic criteria
for the above-mentioned antibody deficiency disorders. (C-M)
