Secondary hypogammaglobulinemia

This article reviews the available data on a common but poorly understood problem, secondary hypogammaglobulinemia. Patients are found to have low immune globulins following an infection, as a consequence of a disease, or as a side effect of a medication. Yet the significance of these depressed immune globulin levels is unclear. The authors review diseases of the kidneys and gastrointestinal tract, malignancies, and rheumatologic disorders that have hypogammaglobulinemia as a frequent finding. The authors also delineate viral infections and common medications that can contribute to this problem. Finally, the approach to the individual who has depressed serum IgG, with or without infections, and how the patient should be evaluated and treated is discussed.