Tuesday, June 30, 2020

Iris Publishers- Open access Journal of Pediatrics & Neonatal Care | Immunoglobulin Levels (IgG, IgM And IgA): Normal Values for Healthy Infants and Children in Sana’a City- Yemen




Authored by Hassan A Al Shamahy*

Abstract

Background: Ig level assessment is often used in the diagnosis and follow up of immunodeficiency, as well as in studies investigate the prevalence of low serum levels in specific diseases.
Objectives: The main objective of this study was to determine the level of immunoglobulin in healthy infants and children in Yemen, to establish a national standard for immunoglobulin level among healthy children based on local data.
Methods:m Immunoglobulin concentration was estimated in 448 healthy children of both sexes of different age groups in Sana’a city. IgG, IgM and IgA serum immunoglobulins were determined by the commercial immunoturbidimetry method. The mean Levels ±SD, 95%CI, minimum, maximum and mode of immunoglobulins (Igs) were calculated and cross tabulation of significant variations were obtained by χ2 and p value.
Results: Four-point two percentage of children showed a high level of IgG, 78.6 % within normal level, and 17.4 % showed a low level. There was no one of tested children showed a high level of IgM, and 94.2 % of them were within normal level, and only 5.8% with low level. Also, 2.2 % showed high level of IgA, 57.6% within normal level and 40.2 % with a low level. The mean level of IgG for both sexes was 910±424mg/dl, while for males was 912±452mg/dl, and for females was 902±404mg/dl. The total mean level of IgM was 96.7±50mg/dl, for males was 96±56mg/dl, and for females was 97±41mg/dl and the variation between sexes was non-significant. The total mean level of IgA was 105±79mg/dl, for males was 98±76mg/dl, and for females was 112±82mg/dl, but the variation was non-significant. The mean values level of all immunoglobulins tested in this study were well correlated with age, where level increase with increasing age.
Conclusion: The study has provided useful information about the normal level of serum immunoglobulins concentration in infants and children, and the results can be taken as a reference values for Yemen. The serum IgG, IgM and IgA levels in most healthy children in our study were within normal range of the international standard, with mean value equal to that reported worldwide.
Keywords: Immunoglobulin; IgG; IgM; IgA; Normal Values; Infants; Children; Yemen

Introduction

Activated B cells differentiate into antibody-producing cells called plasma cells that secrete dissolved antibodies or memory cells that remain in the body for years afterwards in order to allow the immune system to remember the antigen and respond faster at future exposure. Immunoglobulin concentrations (IgG, IgM, and IgA) in sera for healthy children and infants in different age groups were measured and reported in several studies. It was believed to be very diverse among different nations due to environmental and genetic factors [1]. In Yemen, there was no study discussing this issue, and this is the first study of this type while other research studies have been conducted in Yemen to study HLA, immune status against bacterial and viral infections recently [2-6]. There is an important reason to know the concentration of immunoglobulin among children in Yemen as doctors need a precise age-normal range and ethnic-normal range of Igs, so they can diagnose primary immunodeficiency, some autoimmune disorders, HIV Syndromes and various isolated clinical conditions [1,7].
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