Serum immunoglobulin levels in paediatric patients with pneumonia.

Objective: To determine levels of serum immunoglobulins IgG, IgM and IgA in patients admitted with pneumonia to Harare Central Hospital paediatric wards.

Design: A cross sectional pilot study.

Setting: Harare Central Hospital, Department of Immunology, University of Zimbabwe; Department of Paediatrics, University of Zimbabwe; Immunology Laboratory, University of Utrecht (The Netherlands).

Subjects: 71 paediatric patients.

Main Outcome Measures: Immunoglobulin profiles for children with pneumonia.

Results: Of the 71 children tested, 43 had high IgG levels of between two and half and five times the upper end of the normal age-matched reference range. While the same 43 children with high IgG had similarly elevated levels of IgM, only 25 of them had elevated IgA levels. Of this group of 43 children with hypergammaglobulinaemia, all but one, had antibodies to human immunodeficiency virus (HIV), 50% of whom had detectable levels of p24 antigen in their sera. A small minority, 4% of the 71 patients, had very low levels of total immunogloblins.

Conclusions: High levels of total immunoglobulins occur frequently in children with pneumonia and are associated with the presence of HIV 1/2 antibodies and also p24 antigen.