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J Allergy Clin Immunol Pract. 2019 Jan 14. pii: S2213-2198(19)30054-6. doi: 10.1016/j.jaip.2018.12.028. [Epub ahead of print]

Serum IgG Concentrations in Adult Patients Experiencing Virus-Induced Severe Asthma Exacerbations.

Author information

1
Department of Respiratory Medicine, University Hospital Centre of Réunion, Saint-Pierre, France.
2
Department of Respiratory Medicine, University Hospital Centre of Tours, Tours, France.
3
Department of Microbiology, University Hospital Centre of Réunion, Saint-Pierre, France.
4
Department of Virology, University Hospital Centre of Tours, Tours, France.
5
Department of Respiratory Medicine, University Hospital Centre of Toulouse, Toulouse, France; Center for Pathophysiology Toulouse Purpan, INSERM U1043, CNRS UMR 5282, Toulouse III University, Toulouse, France. Electronic address: Guilleminault.l@chu-toulouse.fr.

Abstract

BACKGROUND:

Patients experiencing severe asthma exacerbations have a poorer quality of life and an increase in morbidity and mortality. Viruses are frequently involved in asthma exacerbations.

OBJECTIVE:

To determine the value of measuring serum IgG concentrations in asthma exacerbations and assess their link with viral infections in patients hospitalized for asthma.

METHODS:

Patients hospitalized for asthma exacerbation were included in an observational study from January 1, 2015, to December 31, 2015. Serum IgG concentrations on admission were compared between patients with a positive upper airway viral sample and those with a negative viral sample.

RESULTS:

Among the 82 patients included, those with positive viral nasopharyngeal samples (n = 40) presented with lower serum IgG concentrations during exacerbation than those with a negative viral sample (n = 42) (10.1 ± 2.3 g/L vs 11.5 ± 3.6 g/L; P < .05). The median concentration of serum IgG was lower in patients hospitalized for more than 3 days compared with those hospitalized for less than 3 days (10.0 g/L [8.2-12.4] vs 11.4 g/L [10.1-12.8]; P < .05) and in patients who received oral corticosteroid therapy for more than 5 days compared with those treated with oral steroids for less than 5 days (10.1 g/L [8.3-12.2] vs 11.6 g/L [10.0-13.8]; P < .05).

CONCLUSIONS:

Serum IgG level was significantly lower when asthma exacerbations were associated with positive viral samples. The patients with lower serum IgG concentrations required longer hospitalizations and longer courses of steroids.

KEYWORDS:

Asthma; Exacerbation; IgG; Virus

PMID:
30654200
DOI:
10.1016/j.jaip.2018.12.028

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