{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:02:55Z","timestamp":1760144575940,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Our aim was to determine the secondary antibody deficiency (SAD) profiles of patients in a mesoregion of S\u00e3o Paulo state, Brazil, focusing on infectious diseases. Demographic characteristics, and clinical and laboratory data were obtained from electronic files; infections were classified as organ-specific and graded as mild, moderate, life-threatening, and fatal. Non-Hodgkin\u2019s lymphoma (NHL) accounted for 30% of patients, nephrotic syndrome (NS) 25%, chronic lymphocyte leukemia 20%, and multiple myeloma 15%. Patients with NS were younger than those in other groups, and hypo-\u03b3-globulinemia was detected in 94.1%, IgG &lt; 400 mg\/dL in 60.0%, IgA &lt; 40 mg\/dL in 55.0%, and CD19 &lt; 20 cells\/mm3 in 30.0%. One hundred and one infections were found; 82.1% were classified as mild or moderate, 7.9% as life-threatening, and 3.0% as fatal. Respiratory tract infections were more prevalent (41.5%), and pneumonia accounted for 19.8%. Lower levels of infections were found in patients with NS compared with NHL (p = 0.0001). Most patients progressed to hypo-\u03b3-globulinemia and SAD after treatment with immunosuppressants, and mild and moderate infections were predominant. These therapies are increasing in patients with different diseases; therefore, monitoring hypo-\u03b3-globulinemia and infections may help to identify patients at high risk for severe complications, antibiotic prophylaxis or treatment, and immunoglobulin replacement.<\/jats:p>","DOI":"10.3390\/tropicalmed9050104","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T13:27:00Z","timestamp":1715002020000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infectious Diseases and Secondary Antibody Deficiency in Patients from a Mesoregion of S\u00e3o Paulo State, Brazil"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4577-1525","authenticated-orcid":false,"given":"Luiz Euribel","family":"Prestes-Carneiro","sequence":"first","affiliation":[{"name":"Imunodeficiencies Outpatient Clinic, Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"},{"name":"Master\u2019s Program in Health Sciences, Oeste Paulista University, Presidente Prudente 19050-920, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula Andreia Martins","family":"Carrilho","sequence":"additional","affiliation":[{"name":"Haematology Service, Santa Casa de Misericordia of Presidente Prudente, Presidente Prudente 19014-030, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle Francisco Honorato de Barros","family":"Torelli","sequence":"additional","affiliation":[{"name":"Master\u2019s Program in Health Sciences, Oeste Paulista University, Presidente Prudente 19050-920, Brazil"},{"name":"Outpatient Clinic of Haematology, Nephrology, and Rheumatology, Oeste Paulista University and Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Antonio Nascimento","family":"Bressa","sequence":"additional","affiliation":[{"name":"Outpatient Clinic of Haematology, Nephrology, and Rheumatology, Oeste Paulista University and Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Carolina Gomes","family":"Parizi","sequence":"additional","affiliation":[{"name":"Outpatient Clinic of Haematology, Nephrology, and Rheumatology, Oeste Paulista University and Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Henrique Meireles","family":"Vieira","sequence":"additional","affiliation":[{"name":"Imunodeficiencies Outpatient Clinic, Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"},{"name":"Master\u2019s Program in Health Sciences, Oeste Paulista University, Presidente Prudente 19050-920, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda Miranda Caliani","family":"Sa","sequence":"additional","affiliation":[{"name":"Outpatient Clinic of Haematology, Nephrology, and Rheumatology, Oeste Paulista University and Regional Hospital of Presidente Prudente, Presidente Prudente 19050-680, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio Domingues","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Investigation Unit 56, Hospital das Cl\u0131nicas da Faculdade de Medicina da Universidade de Sao Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.anai.2021.08.413","article-title":"Secondary immunodeficiencies: An overview","volume":"127","author":"Tuano","year":"2021","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"586","DOI":"10.3389\/fimmu.2019.00586","article-title":"Primary and Secondary Immunodeficiency Diseases in Oncohaematology: Warning Signs, Diagnosis, and Management","volume":"10","author":"Sastre","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.iac.2018.08.005","article-title":"Secondary Hypogammaglobulinemia: An Increasingly Recognized Complication of Treatment with Immunomodulators and After Solid Organ Transplantation","volume":"39","author":"Kaplan","year":"2019","journal-title":"Immunol. Allergy Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.iac.2021.07.006","article-title":"Biologic Agents and Secondary Immune Deficiency","volume":"41","author":"Axelrod","year":"2021","journal-title":"Immunol. Allergy Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.kint.2019.12.025","article-title":"Anti-CD20-mediated B-cell depletion in autoimmune diseases: Successes, failures and future perspectives","volume":"97","author":"Crickx","year":"2020","journal-title":"Kidney Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/08923973.2017.1392562","article-title":"Infectious diseases and immunological markers associated with patients with non-Hodgkin lymphoma treated with rituximab","volume":"40","author":"Ferro","year":"2018","journal-title":"Immunopharmacol. Immunotoxicol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/cid\/ciaa127","article-title":"Serious Infectious Events and Immunoglobulin Replacement Therapy in Patients With Autoimmune Disease Receiving Rituximab: A Retrospective Cohort Study","volume":"72","author":"Stabler","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.anai.2023.02.010","article-title":"Secondary immunodeficiencies and infectious considerations of biologic immunomodulatory therapies","volume":"130","author":"Cannon","year":"2023","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/10428194.2021.1992761","article-title":"Risk factors for severe infections in secondary immunodeficiency: A retrospective US administrative claims study in patients with hematological malignancies","volume":"63","author":"Jolles","year":"2022","journal-title":"Leuk. Lymphoma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/ejh.13580","article-title":"Treating secondary antibody deficiency in patients with haematological malignancy: European expert consensus","volume":"106","author":"Jolles","year":"2021","journal-title":"Eur. J. Haematol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"862","DOI":"10.3389\/fimmu.2020.00862","article-title":"Primary Immunodeficiencies in a Mesoregion of S\u00e3o Paulo, Brazil: Epidemiologic, Clinical, and Geospatial Approach","volume":"11","author":"Primo","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3349\/ymj.2010.51.2.239","article-title":"Antibody status in children with steroid-sensitive nephrotic syndrome","volume":"51","author":"Han","year":"2010","journal-title":"Yonsei Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s00281-018-0724-7","article-title":"Sexual dimorphism in solid and hematological malignancies","volume":"41","author":"Meier","year":"2019","journal-title":"Semin. Immunopathol."},{"key":"ref_14","unstructured":"(2023, January 23). World Health Organization, International Agency for Research on Cancer, Global Cancer Observatory. Available online: https:\/\/gco.iarc.fr\/en."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Houpert, R., Almont, T., Belahreche, R., Faro, M., Okouango, J., Vestris, M., Macni, J., Pierre-Louis, O., Montabord, C., and Beaubrun-Renard, M. (2023). A population-based analysis of hematological malignancies from a French-West-Indies cancer registry\u2019s data (2009\u20132018). BMC Cancer, 23.","DOI":"10.1186\/s12885-023-11666-9"},{"key":"ref_16","unstructured":"(2023, February 10). Minist\u00e9rio da Sa\u00fade, Instituto Nacional de C\u00e2ncer Incid\u00eancia de C\u00e2ncer no Brasil, Available online: https:\/\/www.inca.gov.br\/sites\/ufu.sti.inca.local\/files\/media\/document\/estimativa-2023.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Thandra, K.C., Barsouk, A., Saginala, K., Padala, S.A., Barsouk, A., and Rawla, P. (2021). Epidemiology of Non-Hodgkin\u2019s Lymphoma. Med. Sci., 9.","DOI":"10.3390\/medsci9010005"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jaut.2014.11.009","article-title":"Rituximab-associated hypogammaglobulinemia: Incidence, predictors and outcomes in patients with multi-system autoimmune disease","volume":"57","author":"Roberts","year":"2015","journal-title":"J. Autoimmun."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e184169","DOI":"10.1001\/jamanetworkopen.2018.4169","article-title":"Association of Immunoglobulin Levels, Infectious Risk, and Mortality With Rituximab and Hypogammaglobulinemia","volume":"1","author":"Barmettler","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1002\/eji.202149667","article-title":"Secondary rituximab-associated versus primary immunodeficiencies: The enigmatic border","volume":"52","author":"Ottaviano","year":"2022","journal-title":"Eur. J. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1038\/s41408-020-00346-7","article-title":"Infection during the first year in patients treated with CD19 CAR T cells for diffuse large B cell lymphoma","volume":"10","author":"Wudhikarn","year":"2020","journal-title":"Blood Cancer J."},{"key":"ref_22","first-page":"752","article-title":"Sex in infectious diseases-How sex differences influence the immune response to infections","volume":"64","author":"Horn","year":"2023","journal-title":"Inn. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/s41597-020-00668-y","article-title":"Systematic analysis of infectious disease outcomes by age shows lowest severity in school-age children","volume":"7","author":"Glynn","year":"2020","journal-title":"Sci. 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