Investigation of transient hypogammaglobulinemia of infancy in the etiology of chronic cough in children under five years old

Chronic cough is one of the most common complaints of childhood to consult a doctor. There are many causes such as respiratory tract infections, gastroesophageal reflux, persistent bacterial bronchitis, asthma, cystic fibrosis, congenital malformations, and foreign body aspiration in children under the age of five. However, neither transient hypogammaglobulinemia of infancy (THI) among the causes of chronic cough, nor chronic cough among the application complaints of THI are not questioned. In this study, we aimed to draw attention to the role of THI in the etiology of chronic cough under the age of five. Our study included 55 pediatric patients under the age of five who applied to the pediatric pulmonary diseases outpatient clinic in between January 2015 and December 2020 with the complaint of chronic cough, who were excluded from other causes of chronic cough in etiology, and who met the criteria for THI according to the European Society for Immunodeficiencies (ESID). Demographic, clinical and laboratory characteristics and follow-ups of these patients were reviewed retrospectively. In our study, the mean age of 55 patients at admission was 21.73 ± 11.50 months (median age: 18 months), and the mean age of IgG recovery was 38.65 ± 16.81 months. The mean recovery time was 16.93 ± 12.85 months. Of the patients, 22.4% had a history of consanguinity, 23.4% had prematurity, and 18.2% had a frequent sickness in siblings. The most common complaint accompanying chronic cough in patients was frequent respiratory tract infection, 16.3%. Along with IgG, 26.4% of the patients had low IgA and 31.5% had low IgM in laboratory testing. In antibody responses, isohemagglutinin, anti-tetanus, anti-pneumococcal, anti-HBs vaccine responses were found to be positive in 90.6%, 63.9%, 66.7% and 97.7% of the cases, respectively. 72.7% of the patients received inhaler treatment, 45.5% received antibiotic prophylaxis, and 2.2% received intravenous immunoglobulin (IVIg) treatment. After the IgG value of the patients returned to normal, it ...