IgG and IgG subclasses deficiency in children undergoing continuous ambulatory peritoneal dialysis and its provocative factors

AKMAN, SEMA
GÜVEN, AYFER GÜR
INCE, SELMA
YEĞIN, OLCAY

¹Department of Pediatric Nephrology, Akdeniz University Medical Faculty, Antalya, Turkey
²Department of Immunology, Akdeniz University Medical Faculty, Antalya, Turkey

Correspondence: Dr Sema Akman, Akdeniz University Medical Faculty, Department of Pediatric Nephrology, Antalya, 07070, Turkey. Email: [email protected]

Received 29 March 2001; revised 29 August 2001; accepted 5 October 2001.

Pediatrics International 44(3):p 273-276, June 2002.

Background

Low levels of serum IgG or IgG subclasses may be responsible for the defective peritoneal defense and for peritonitis attacks in continuous ambulatory peritoneal dialysis (CAPD) children. Malnutrition, peritoneal loss or frequent peritonitis may lead to IgG or IgG subclasses deficiency.

Methods

Levels of IgG subclasses were determined in 12 children undergoing CAPD treatment. Radial immunodiffusion technique was used for determination. Patients were aged from 6 to 16 years (mean age 12.3 years) and had been on CAPD for 11–26 months (mean duration 19.4 months). We evaluated whether IgG and IgG subclasses deficiency are related to malnutrition, the peritonitis rate and the duration of CAPD using the SPSS program.

Results

Serum total IgG levels were found to be low in eight out of 12 patients. Eight patients showed low levels of IgG1, four patients IgG2, one patient IgG3 and three patients IgG4. Total IgG values were found to be positively correlated to malnutrition status, peritonitis rate and duration of CAPD. The IgG2 values were found to be related to the duration of CAPD. The IgG4 values were found to be correlated to the peritonitis rates.

Conclusions

The IgG and IgG subclasses deficiency may develop in children while on CAPD treatment. Periodical determinations of either serum IgG or the subclasses may be useful in the follow-up of these patients.