{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T06:35:00Z","timestamp":1773815700793,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Antibody deficiencies, particularly Common Variable Immunodeficiency (CVID), represent a major health concern due to comorbidities linked to delayed diagnosis. Calculated globulin (CG) and the gammaglobulins derived from serum protein electrophoresis have been proposed as reliable indices for screening hypogammaglobulinemia. This study aimed to establish optimal cut-offs for CG and the gammaglobulins to identify patients with low IgG among hospitalized adolescents and adults from Algeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum samples and clinical data were collected from hospitalized patients aged over 10 years. Total protein and albumin were determined by the biuret and bromocresol green methods, IgG was quantified by nephelometry, and gammaglobulins were determined by gel or capillary serum protein electrophoresis. In addition, a control group was included for cut-off verification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 980 patients were recruited, including 762 adults (\u2265 18 years) and 218 adolescents (10\u201317 years), with a median age of 47 years. The control group comprised 20 patients with confirmed CVID. The most frequent clinical manifestations were autoimmune disorders (33%), inflammatory disorders (31%), and severe infections (24%). Hypogammaglobulinemia was identified in 94 patients, including 6 with primary causes. IgG levels correlated significantly with both CG and gammaglobulins. Linear regression analysis showed that IgG accounted for 49% of the variance in CG and 75% in the gammaglobulins. A CG cut-off value of 22 g\/L yielded a sensitivity of 80% and a specificity of 87%, whereas a gammaglobulin cut-off of 8.9 g\/L achieved a sensitivity of 96% and a specificity of 88%. Gammaglobulin cut-off values were consistent between adult and pediatric groups, while differences in CG cut-offs were observed (adult group: 22.25 g\/L; pediatric group: 24.15 g\/L). Thirteen of the 20 patients with CVID in the control group (65%) had a CG level below 22 g\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CG and serum protein electrophoresis are reliable tools for screening hypogammaglobulinemia. Although both tests demonstrated satisfactory sensitivity and specificity, certain cases may be underestimated or overestimated. Therefore, thorough clinical evaluation and, whenever possible, direct immunoglobulin measurement remain essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1734197","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T05:38:51Z","timestamp":1773812331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving screening for antibody deficiency using calculated globulin and serum protein electrophoresis"],"prefix":"10.3389","volume":"17","author":[{"given":"Linda","family":"Mokrane","sequence":"first","affiliation":[{"name":"Department of Medical Biology, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azzeddine","family":"Tahiat","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sihem","family":"Taguemount","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassen","family":"Messaoudi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Boukhenfouf","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rouiba Hospital","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelbassat","family":"Ketfi","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Smati","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bologhine Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachida","family":"Boukari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mustapha University Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamel","family":"Djenouhat","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, Rouiba Hospital, Algiers University of Health Sciences","place":["Algiers, Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"B1","first-page":"i","volume-title":"Immunology, infection, and immunity","author":"Wetzler","year":"2015"},{"key":"B2","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijbiomac.2020.12.073","article-title":"Role of immunoglobulin and antibodies in disease management","volume":"169","author":"Megha","year":"2021","journal-title":"Int J Biol Macromolecules"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.73.2.133","article-title":"Evaluating and managing hypogammaglobulinemia","volume":"73","author":"Rose","year":"2006","journal-title":"Clev Clin J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1006\/clim.1999.4799","article-title":"Diagnostic criteria for primary immunodeficiencies","volume":"93","author":"Conley","year":"1999","journal-title":"Clin Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2014.09.009","article-title":"Should mild hypogammaglobulinemia be managed as severe hypogammaglobulinemia? 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