{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:08:54Z","timestamp":1782450534393,"version":"3.54.5"},"reference-count":67,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T00:00:00Z","timestamp":1616889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Immunoglobulins play a fundamental role in the protection of the human body against internal and external threats. They also contribute to the immune system homeostasis and maintenance of self-tolerance. Hypogammaglobulinemia is occasionally encountered in routine clinical practice by rheumatologists. Low levels of immunoglobulins can occur as primary or secondary issues and may predispose patients to various forms of infection. However, the impact of the low immunoglobulin level abnormality varies with the underlying condition. In this narrative review, we shed light on the overall types and functions of immunoglobulins for clinicians. We discuss important principles of immunoglobulin measurements. We then consider the primary and secondary causes of low immunoglobulins with a special focus on hypogammaglobulinemia in patients with systemic lupus erythematosus (SLE).<\/jats:p>","DOI":"10.1177\/09612033211004714","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T01:32:01Z","timestamp":1616981521000},"page":"867-875","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Immunoglobulin levels in systemic lupus erythematosus: A narrative review"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8176-287X","authenticated-orcid":false,"given":"Ibrahim","family":"Almaghlouth","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital, University of Toronto and the Schroeder Arthritis Institute, University Health Network, Toronto, Canada"},{"name":"Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia"},{"name":"College of Medicine Research Center, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu R","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital, University of Toronto and the Schroeder Arthritis Institute, University Health Network, Toronto, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Pullenayegum","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada"},{"name":"Program in Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafna","family":"Gladman","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital, University of Toronto and the Schroeder Arthritis Institute, University Health Network, Toronto, Canada"},{"name":"Centre for Prognosis in Rheumatic Diseases, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7506-9166","authenticated-orcid":false,"given":"Murray","family":"Urowitz","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital, University of Toronto and the Schroeder Arthritis Institute, University Health Network, Toronto, Canada"},{"name":"Centre for Prognosis in Rheumatic Diseases, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2013.00200"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.09.046"},{"key":"e_1_3_2_4_2","first-page":"115","article-title":"Human immunoglobulin subclasses","volume":"5","author":"Normansell DE.","year":"1987","unstructured":"Normansell DE. Human immunoglobulin subclasses. Diagn Clin Immunol 1987; 5: 115\u2013128.","journal-title":"Diagn Clin Immunol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-5890(01)00025-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2567.2006.02386.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00520"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00389"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-2896.2005.00290.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.178.1.27"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2011.01024.x"},{"key":"e_1_3_2_12_2","first-page":"797","article-title":"Seasonal effect on the variability of summer immunoglobulin levels","volume":"55","author":"Nordby GL","year":"1983","unstructured":"Nordby GL, Cassidy JT. Seasonal effect on the variability of summer immunoglobulin levels. Hum Biol 1983; 55: 797\u2013809.","journal-title":"Hum Biol"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.1860090107"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.07.025"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2007.03545.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00626"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090856"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12178"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.09.023"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2002.122466"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-09-377945"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2009.12.004"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S139248"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.22211"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08076.x"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket257"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-582346"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2018.02.010"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0100324"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03400.x"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e318289bb9b"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138753"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1006\/jaut.1998.0236"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311411598"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken255"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e31817a90ba"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2006.09.005"},{"key":"e_1_3_2_38_2","first-page":"13","article-title":"Systemic lupus erythematosus and IgA deficiency","volume":"10","author":"Yewdall V","year":"1983","unstructured":"Yewdall V, Cameron JS, Nathan AW, et\u00a0al. Systemic lupus erythematosus and IgA deficiency. J Clin Lab Immunol 1983; 10: 13\u201318.","journal-title":"J Clin Lab Immunol"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.2119\/molmed.2011.00195"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1080\/08916930802375711"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2012.00210"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1111810108"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-7613(00)00027-3"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1102321"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.30613"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22993"},{"key":"e_1_3_2_47_2","first-page":"83","article-title":"The association of autoimmune diseases and anti-IgA antibodies in patients with selective IgA deficiency","volume":"37","author":"Petty RE","year":"1979","unstructured":"Petty RE, Palmer NR, Cassidy JT, et\u00a0al. The association of autoimmune diseases and anti-IgA antibodies in patients with selective IgA deficiency. Clin Exp Immunol 1979; 37: 83\u201388.","journal-title":"Clin Exp Immunol"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2017-000229"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780301112"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310929"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa641"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203312469259"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41927-019-0079-2"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307077543"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/096120339700600408"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203319896018"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm1763"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.200254"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13263"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2020.04.033"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217864"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217549"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008423"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.3.238"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313493032"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307086503"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar2764"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1385\/CRIAI:29:3:219"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033211004714","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033211004714","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033211004714","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:23:36Z","timestamp":1777677816000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033211004714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,28]]},"references-count":67,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/09612033211004714"],"URL":"https:\/\/doi.org\/10.1177\/09612033211004714","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,28]]}}}