{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:34:58Z","timestamp":1784280898828,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Antibody deficiency may be primary, because of an underlying inborn error of immunity, or secondary, due to another disease process or medication, leading to decreased antibody production or increased antibody loss. Secondary antibody deficiency is much more common than primary. It can, however, be difficult to distinguish primary from secondary, and both should be considered when assessing patients with hypogammaglobulinaemia. The case presented highlights the importance of confirming the underlying pathophysiology in patients presenting with antibody deficiency, the contribution of genetic assessment to the care of patients with complex phenotypes, and the impact this can have on long-term patient management.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1629876","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T06:29:30Z","timestamp":1762756170000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: A simple case of drug-induced secondary antibody deficiency or a rare primary immune deficiency?"],"prefix":"10.3389","volume":"16","author":[{"given":"Sarah L.","family":"Johnston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian R.","family":"Berry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver T.","family":"Watkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"B1","unstructured":"NHS England Clinical Commissioning Policy for the use of therapeutic immunoglobulin (Ig) England\n          \n          2025"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.01.025","article-title":"Practical guidance for the diagnosis and management of secondary hypogammaglobulinaemia: A Work Group Report of the AAAAI Primary Immunodeficiency and Altered Immune Response Committees","volume":"149","author":"Otani","year":"2022","journal-title":"J Allergy Clin Immunol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-012-1153-3","article-title":"Valproate-induced panhypogammaglobulinaemia","volume":"34","author":"Eom","year":"2013","journal-title":"Neurol Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1989.00390060133029","article-title":"Reversible common variable immunodeficiency syndrome induced by phenytoin","volume":"149","author":"Travin","year":"1989","journal-title":"Arch Intern Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.60.4.459","article-title":"Hypogammaglobulinaemia with absent B lymphocytes and agranulocytosis after carbamazepine treatment","volume":"60","author":"Spikett","year":"1996","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.090266","article-title":"Recurrent herpes simplex virus encephalitis secondary to carbamazepine induced hypogammaglobulinaemia","volume":"78","author":"Rice","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0004.1999.550206.x","article-title":"Antibody deficiency, growth retardation, spondyloepiphyseal dysplasia and retinal dystrophy: a novel syndrome","volume":"55","author":"Roifman","year":"1999","journal-title":"Clin Genet"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-313X.2011.01041.x","article-title":"Is Roifman syndrome an X-linked ciliopathy with humoral immunodeficiency? 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