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Inborn errors of immunity, mainly Predominantly Antibody deficiencies with normal IgG levels, are unrecognized in adults with lung diseases such as bronchiectasis or recurrent pneumonia.


To determine IgM, IgA, IgG2 subclass deficiencies, and Specific antibody deficiency (anti-pneumococcal polysaccharide antibodies) in adults with non-cystic fibrosis bronchiectasis or recurrent pneumonia.


Cross-sectional study. Consecutive patients with non-cystic fibrosis bronchiectasis or recurrent pneumonia were recruited in Cali, Colombia. IgG, IgA, IgM; IgE, IgG2 subclass, and IgG anti-pneumococcal serum levels were measured.


Among the 110 participants enrolled, Antibody deficiencies with normal serum IgG levels were found in 11(10%) cases. IgA deficiency (3 cases), IgM deficiency (2 cases), and IgG2 deficiency (2 cases) were the most frequent primary immunodeficiencies. In addition, IgG2+IgA deficiency, Ataxia-telangiectasia, Hyper-IgE syndrome and Specific Antibody Deficiency(anti-polysaccharides) were found in one case each.


Predominantly antibody deficiencies with normal IgG levels are an important etiology of non-cystic fibrosis bronchiectasis and recurrent pneumonia in adults.


Andres F Zea-Vera, Universidad del Valle, Escuela de Ciencias Básicas, Departamento de Microbiología, Grupo de investigación VIREM, Cali, Colombia


Mario Alejandro Chacón, MD, Universidad del Valle, Escuela de Ciencias Básicas, Departamento de Microbiología, Grupo de investigación VIREM, Cali, Colombia



Beatriz Parra, Universidad del Valle, Escuela de Ciencias Básicas, Departamento de Microbiología, Grupo de investigación VIREM, Cali, Colombia


Zea-Vera, A. F., Chacón, M. A., & Parra, B. (2023). Antibody deficiencies with normal IgG in adults with Non-cystic fibrosis bronchiectasis or recurrent pneumonia: Cross-sectional study. Colombia Medica, 53(2), e2014832. (Original work published July 11, 2022)

Mahlaoui N, Warnatz K, Jones A, Workman S, Cant A. Advances in the care of primary immunodeficiencies (PIDs): from birth to adulthood. J Clin Immunol. 2017; 37(5): 452-60.

McCusker C, Upton J, Warrington R. Primary immunodeficiency. Allergy Asthma Clin Immunol. 2018; 14(S2): 61.

Tangye SG, Al-Herz W, Bousfiha A, Chatila T, Cunningham-Rundles C, Etzioni A, et al. Human inborn errors of immunity: 2019 update on the classification from the international union of immunological societies expert committee. J Clin Immunol. 2020; 40(1): 24-64.

Slade CA, Bosco JJ, Giang TB, Kruse E, Stirling RG, Cameron PU, et al. Delayed diagnosis and complications of predominantly antibody deficiencies in a cohort of Australian adults. Front Immunol. 2018; 9: 694.

Kashani S, Carr TF, Grammer LC, Schleimer RP, Hulse KE, Kato A, et al. Clinical characteristics of adults with chronic rhinosinusitis and specific antibody deficiency. J Allergy Clin Immunol Pract. 2015; 3(2): 236-42.

Tabatabaie P, Aghamohammadi A, Mamishi S, Isaeian A, Heidari G, Abdollahzade S, et al. Evaluation of humoral immune function in patients with bronchiectasis. Iran J Allergy Asthma Immunol. 2008; 7(2): 69-77.

Perez E, Bonilla FA, Orange JS, Ballow M. Specific antibody deficiency: Controversies in diagnosis and management. Front Immunol. 2017; 8:586.

Orange JS, Ballow M, Stiehm ER, Ballas ZK, Chinen J, De La Morena M, et al. Use and interpretation of diagnostic vaccination in primary immunodeficiency: A working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2012; 130(3 Suppl): S1-24.

Rezaei N, Aghamohammadi A, Siadat SD, Nejati M, Ahmadi H, Moin M, et al. Serum bactericidal antibody response to serogroup C polysaccharide meningococcal vaccination in children with primary antibody deficiencies. Vaccine. 2007; 25(29): 5308-14.

Huo ZM, Miles J, Riches PG, Harris T. Limitations of Pneumovax® as a detection antigen in the measurement of serotype-specific antibodies by enzyme-linked immunosorbent assay. Ann Clin Biochem. 2002; 39(4): 398-403.

Zea-Vera AF, Agudelo-Rojas OL. Disseminated Bronchiectasis in an adult with Common Variable Immunodeficiency. Colomb Med (Cali). 2015; 46(1): 47-50.

European Society for Immunodeficiencies. ESID Registry - Working definitions for clinical diagnosis of PID. 2014. Available from:

Qi Q, Wang W, Li T, Zhang Y, Li Y. Aetiology and clinical characteristics of patients with bronchiectasis in a Chinese Han population: A prospective study. Respirology. 2015; 20(6): 917-24.

Aghamohammadi A, Moin M, Karimi A, Naraghi M, Zandieh F, Isaeian A, et al. Immunologic evaluation of patients with recurrent ear, nose, and throat infections. Am J Otolaryngol. 2008; 29(6): 385-92.

Invitrogen. Human IgG2 ELISA Kit. 2019. Cited: 2021 Mar 26.

Koskela M. Serum antibodies to pneumococcal C polysaccharide in children: Response to acute pneumococcal otitis media or to vaccination. Pediatr Infect Dis J. 1987; 6(6): 519-26.

Leal-Esteban LC, Rojas JL, Jaimes AL, Montoya JD, Montoya NE, Leiva L, et al. An immunoenzymatic test for IgG antibody levels against 10 serotypes of Streptococcus pneumoniae. Biomédica. 2011; 32(1): 92-102.

Dimakou K, Triantafillidou C, Toumbis M, Tsikritsaki K, Malagari K, Bakakos P. Non CF-bronchiectasis: Aetiologic approach, clinical, radiological, microbiological and functional profile in 277 patients. Respir Med. 2016; 116:1-7.

Anwar GA, McDonnell MJ, Worthy SA, Bourke SC, Afolabi G, Lordan J, et al. Phenotyping adults with non-cystic fibrosis bronchiectasis: A prospective observational cohort study. Respir Med. 2013; 107(7): 1001-7.

McShane PJ, Naureckas ET, Strek ME. Bronchiectasis in a diverse US population: Effects of ethnicity on etiology and sputum culture. Chest. 2012; 142(1): 159-67.

May A, Zielen S, Von Ilberg C, Weber A. Immunoglobulin deficiency and determination of pneumococcal antibody titers in patients with therapy-refractory recurrent rhinosinusitis. Eur Arch Oto-Rhino-Laryngology. 1999; 256(9): 445-9.

Ruffner MA, Aksamit TR, Thomashow B, Choate R, DiMango A, Turino GM, et al. Frequency of untreated hypogammaglobulinemia in bronchiectasis. Ann Allergy Asthma Immunol . 2017; 119(1): 83-5.

Parker AR, Skold M, Ramsden DB, Ocejo-Vinyals JG, López-Hoyos M, Harding S. The Clinical Utility of Measuring IgG Subclass Immunoglobulins During Immunological Investigation for Suspected Primary Antibody Deficiencies. Lab Med. 2017; 48(4): 314-25.

Ladomenou F, Gaspar B. How to use immunoglobulin levels in investigating immune deficiencies. BMJ; 2016. 101(3): 129-35.

Aytekin C, Tuygun N, Gokce S, Dogu F, Ikinciogullari A. Selective IgA deficiency: Clinical and laboratory features of 118 children in Turkey. J Clin Immunol. 2012; 32(5): 961-6.

Adebajo AO, Wright JK, Cawston TE, Hazleman BL. Rheumatoid factor quantitation: A comparison of ELISA and nephelometric methods . Medical Laboratory Sciences. 1991; 48(1):47-51.

Aazami H, Seif F, Ghalehbaghi B, Mohebbi A, Ahmadi A, Babaheidarian P, et al. Levels of total IgA and IgA subclasses in the serum of chronic rhinosinusitis patients. Med J Islam Repub Iran. 2018; 32(1): 1-4.

Parra EL, Ramos V, Sanabria O, Moreno J. Serotype and genotype distribution among invasive Streptococcus pneumoniae isolates in Colombia, 2005-2010. PLoS One. 2014; 9(1): e84993.


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Received 2021-05-10
Accepted 2022-05-05
Published 2023-05-04