Two
patients with recurrent sinopulmonary
infections and normal total
serum immunoglobulin levels were found to have selective deficiencies in
IgG subclasses. The
serum of one
patient contained abnormally low
IgG2 and
IgG4; and the other was deficient in
IgG4. Both
patients responded to the
treatment with high
dose intravenous immunoglobulin. The experiences on these two cases strongly suggest that
IgG subclasses should be checked in
patients with recurrent sinopulmonary
infections in
face of normal total
immunoglobulins.