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Table 8. Assessing Serotype-Specific Responses to
Pneumococcal Capsular Polysaccharides
Phenotype Age <6 y Age >6 y
Mild Concentration >1.3 μg/mL for
>50% of types with a 2-fold
increase for <50% of serotypes
Concentration >1.3 μg/mL for
>70% of types with a 2-fold
increase for <70% of serotypes
Moderate Concentration >1.3 μg/mL for
<50% of serotypes
Concentration >1.3 μg/mL for
<70% of serotypes
Severe Concentration >1.3 μg/mL for ≤2 serotypes
Memory Loss of response within 6 mo
Adapted from Orange et al. J Allerg y Clin Immunol. 2012;130(suppl):S1-S24.
Transient hypogammaglobulinemia of infancy (THI)
Î SS 107. Infants and young children with frequent viral and bacterial
respiratory illnesses and low IgG levels with normal vaccine responses
should be given a diagnosis of THI. (C)
Î SS 108. The principles of management of THI should follow those for
antibody deficiency. (C)
Immunoglobulin class-switch defects
Î SS 109. Patients with immunoglobulin class-switch defects should be
clearly differentiated from those with other forms of CID with similar
screening laboratory findings. (C)
Î SS 110. The principles of management of immunoglobulin class-switch
defects should follow those for antibody deficiency. (C)
Î SS 111. Autoimmune, lymphoproliferative, or malignant diseases
associated with immunoglobulin class-switch defects are treated as
they would be in other clinical settings. (C)
Unspecified hypogammaglobulinemia
Î SS 112. Any patient with primary hypogammaglobulinemia and
normal cellular immunity who does not fulfill the diagnostic criteria
for the above disorders should be given a diagnosis of unspecified
hypogammaglobulinemia. (D)
Î SS 113. Management of unspecified hypogammaglobulinemia should
adhere to the general principles presented for antibody deficiency. (D)
