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Hydroxychloroquine Therapy and Serum Immunoglobulin Levels in Women with IgG Subclass Deficiency and Systemic Lupus Erythematosus, Sjögren Syndrome, and Rheumatoid Arthritis: A Retrospective Study

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Archivum Immunologiae et Therapiae Experimentalis Aims and scope

Abstract

Hydroxychloroquine (HCQ) therapy decreased immunoglobulin (Ig) levels in patients with Sjögren syndrome (SS) and rheumatoid arthritis (RA) in previous studies. We found no report of Ig levels of women with IgG subclass deficiency (IgGSD) and systemic lupus erythematosus (SLE), SS, or RA treated with HCQ. We retrospectively evaluated IgG, IgG subclass, IgA, and IgM levels and other characteristics of women at IgGSD diagnosis who did and did not take HCQ for SLE, SS, or RA. There were 132 women (48 subnormal IgG1 only, 49 combined subnormal IgG1/IgG3, and 35 subnormal IgG3 only). Mean age was 49 ± 13 years. Twenty-two women with SLE, SS, RA, or combination thereof reported HCQ ≥ 200 mg/day ≥ 6 months. In each IgGSD subtype, median Ig levels of women who took HCQ were not significantly lower than those of women who did not take HCQ. Women with combined subnormal IgG1/IgG3 who took HCQ had greater median IgG2 than women who did not take HCQ (4.89 g/L (range 4.43, 4.94) vs. 2.57 g/L (1.21, 6.44), respectively; p = 0.0123). Regressions on IgG1, IgG2, and IgG3 revealed positive associations with HCQ therapy (p = 0.0043, 0.0037, and 0.0139, respectively). There were no significant Ig associations with age, SLE, SS, or RA as independent variables. HCQ therapy of SLE, SS, or RA in women with IgGSD was not associated with significantly lower IgG, IgG subclass, IgA, or IgM levels. IgG1, IgG2, and IgG3 were positively associated with HCQ therapy, after adjustment for other variables.

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The authors did not receive outside support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    James C. Barton

  2. Southern Iron Disorders Center, Birmingham, AL, USA

    James C. Barton & J. Clayborn Barton

  3. Department of Medicine, Brookwood Medical Center, Birmingham, AL, USA

    James C. Barton & Luigi F. Bertoli

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  1. James C. Barton
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  2. J. Clayborn Barton
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  3. Luigi F. Bertoli
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Contributions

JaCB: conceptualization, data curation, formal analysis, investigation, methodology, project administration, visualization, writing—original draft preparation, and writing—review and editing. JClB: data curation, formal analysis, investigation, visualization, and writing—original draft preparation. LFB: formal analysis, resources, visualization, writing—original draft preparation, and writing—review and editing.

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Correspondence to James C. Barton.

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Barton, J.C., Barton, J.C. & Bertoli, L.F. Hydroxychloroquine Therapy and Serum Immunoglobulin Levels in Women with IgG Subclass Deficiency and Systemic Lupus Erythematosus, Sjögren Syndrome, and Rheumatoid Arthritis: A Retrospective Study. Arch. Immunol. Ther. Exp. 70, 14 (2022). https://doi.org/10.1007/s00005-022-00652-x

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