Serum levels of immunoglobulins and severity of community-acquired pneumonia
de la Torre, Maria del Carmen (Hospital de Mataró. Consorci Sanitari del Maresme)
Torán, Pere (Unitat Suport Recerca Metropolitana Nord ICS, Santa Coloma de Gramanet)
Serra-Prat, Mateu (Hospital de Mataró. Consorci Sanitari del Maresme)
Palomera, Elisabet (Hospital de Mataró. Consorci Sanitari del Maresme)
Güell, Estel (Hospital de Mataró. Consorci Sanitari del Maresme)
Vendrell, Ester (Hospital de Mataró. Consorci Sanitari del Maresme)
Yébenes, Juan Carlos (Hospital de Mataró. Consorci Sanitari del Maresme)
Torres, Antoni (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Almirall i Pujol, Jordi (Hospital de Mataró. Consorci Sanitari del Maresme)
Universitat Autònoma de Barcelona

Date:	2016
Abstract:	There is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome. This was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191). Serum total IgG (and IgG subclasses IgG1, IgG2, IgG3, IgG4), IgA and IgM were measured at the first clinical visit. Normal cutpoints were defined as the lowest value obtained in controls (≤680, ≤323, ≤154, ≤10, ≤5, ≤30 and ≤50 mg/dL for total IgG, IgG1, IgG2, IgG3, IgG4, IgM and IgA, respectively). Serum immunoglobulin levels decreased in relation to severity of CAP. Low serum levels of total IgG, IgG1 and IgG2 showed a relationship with ICU admission. Low serum level of total IgG was independently associated with ICU admission (OR=2. 45, 95% CI 1. 4 to 4. 2, p=0. 002), adjusted by the CURB-65 severity score and comorbidities (chronic respiratory and heart diseases). Low levels of total IgG, IgG1 and IgG2 were significantly associated with 30-day mortality. Patients with severe CAP admitted to the ICU showed lower levels of immunoglobulins than non-ICU patients and this increased mortality.
Note:	Altres ajuts: This work was supported by a grant (08/PI 090448) from Fondo de Investigaciones Sanitarias (FIS) and CIBER de Respiratorio (06/06/0028), Madrid, Spain and a grant from 'Fundació Salut del Consorci Sanitari del Maresme'.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Immunodeficiency ; Pneumonia ; Respiratory Infection
Published in:	BMJ Open Respiratory Research, Vol. 3 (november 2016) , ISSN 2052-4439

DOI: 10.1136/bmjresp-2016-000152
PMID: 27933180

7 p, 824.3 KB

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