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반복적인 호흡기 감염과 천식 악화가 동반된 IgG3 아형 결핍증 성인 환자에서 intravenous immunoglobulin 사용 1예
이홍열 ( Hong Yeul Lee ),윤상원 ( Sang Won Yoon ),김영 ( Young Kim ),조환준 ( Hwan Jun Cho ),이주영 ( Joo Young Lee ),구강모 ( Kang Mo Gu ),박태연 ( Tae Yun Park ),최재철 ( Jae Chol Choi ),신종욱 ( Jong Wook Shin ),김재열 ( Jae Y 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.3
The IgG subclass deficiency is defined as a significant decrease in the serum concentrations of one or more subclasses of IgG in a patient whose total IgG concentration is normal. IgG subclass deficiency can predispose to recurrent sinopulmonary infections. A 29-year-old female patient with a 4-year history of bronchial asthma presented with cough, sputum, dyspnea, and recurrent respiratory infections. She had frequently been treated with antibiotics and systemic steroids for recurrent respiratory infections and acute asthma exacerbations. Chest X-ray and computed tomography showed pectus excavatum and bronchial wall thickening without lung parenchymal abnormalities. On immunological evaluation, she was found to have a low serum IgG3, with normal total IgG concentration. Under diagnosis of selective IgG3 deficiency, she was started on monthly infusions of intravenous immunoglobulin (IVIG) therapy. The frequency and severity of respiratory infections and acute asthma exacerbations were markedly decreased during 3 years of IVIG therapy. Our case report suggests that a patient who has underlying selective IgG3 deficiency and asthma may benefit from IVIG therapy as this can significantly reduce the incidence and severity of recurrent respiratory infections and acute asthma exacerbations. (Allergy Asthma Respir Dis 2016;4:225-229)