Hi! I don't know which subclass exactly I'm deficient in, but my IgG was 420 the first time it was checked. The only treatment I'm on is preventative antibiotics twice a week, since I have recurrent infections. I've not been able to get IVIG because my titers to the pneumonia and tetanus vaccines were normal, but it seems to me that I make antibodies to vaccines initially, but then lose the antibodies. I had the Hep B series and had the titer drawn a few years later for my employer and had no immunity, so they gave me a booster. Then I had full immunity. They checked it again, and now I'm back to none. Much to my surprise, though, my IgG had actually went up when it was checked in mid December to 500. My doctor actually was going to put me on IVIG with the levels I have, but isn't going to now because I did make antibodies to the pneumonia and tetanus. I've not been able to talk to my doctor since the Hep B titers were drawn, so I really don't know where we'll go from here. I can tell that the preventative antibiotics are helping, because I was constantly (and I mean constantly) on antibiotics for some kind of infection, usually sinus or respiratory before I was put on the twice weekly antibiotic. Since July, I've had to take antibiotics three times and even though that's not great, it's much better than before.

Hi, thanks for your reply. I too had the Hep B vaccination for work and had a rubbish result. As I had severe neutropenia for 6 months after the first course, I've refused another go. A year ago I was at 520, now at 450 so it will be interesting to see what happens when I get another check in April.

I find the antibiotics a bother. I have to take it well before eating. If I take it with a meal I get stomach ache and the runs. I've only been taking it for two weeks so maybe my body will adjust.

I agree. The antibiotics are a pain. I actually have the opposite problem with them. If I don't eat something first, I get really sick. My doctor actually told me that these make him sick at the dose I 'm on, so at least I wasn't surprised. He told me that I could break the dose up if I needed to. I've found that if I don't take the larger dose at once, I start feeling like I'm coming down with a sinus infection and/or bronchitis. I think that there must be some confusion among my doctors as to what I actually have. They told me that I have CVID, then called and told me that I didn't. I ended up having a lot of joint pain and got sent to a rheumatologist, and he told me that I do have it. He's sending me back to the first doctor I went to. He's booked for a long time, so I don't go to him until April. He's not made up his mind about the IVIG for sure. I really wish I could get this all figured out before open enrollment!

I have sub class deficiency, ostensibly, but am very low across the board and have no response to the pneumonia vax. I have been on treatment since 2004. I hope you are able to go on treatment at some point. It really helps!

I have all four subclasses low as well as CVID and no t-cell response (as well as not building antibodies to the pnumo vac). Your IgG number is certainly low enough to receive treatment of IgG. I would ask for a second opinion from another doc (you can get a referral list from IDF). My first immuno was really just an allergist and very inept. He put me on prophylactic antis for several months as he struggled to get the ins. company to approve me (btw my second doc got me approved in 5 days). And now none of the antis with Azithromycin work for me, including the big guns. For me, that was a mistake. Doing much better a year into treatment, fighting off colds etc.

Hi there,

I tend to agree with Teal about getting a second opinion. In my opinion if you have low IGG and poor/no response to pneumo vaccine then its cvid.

That being said, the standard treatment for subclass deficiency is NOT necessarily IGG replacement, which could be why he is not doing it. Here is an excerpt from Immunedisease.com:

"The use of immunoglobulin replacement therapy in patients with IgG subclass deficiencies is not as clear cut as it is for X-linked agammaglobulinemia and Common Variable Immunodeficiency patients.

Patients with IgG subclass deficiency and/or specific antibody deficiency have a more limited antibody and immunoglobulin deficiency than patients with X-linked Agammaglobulinemia and Common Variable Immunodeficiency. For patients in whom infections and symptoms can be controlled with antibiotics, immunoglobulin replacement therapy may not be necessary. However, for patients whose infections cannot be readily controlled with antibiotics, or have abnormal antibody responses, immunoglobulin replacement therapy may be considered."