Taiwan College of Rheumatology
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Taiwan College of Rheumatology
Osler answers from this library and names the guideline behind every claim.
Secondary hypogammaglobulinemia (SHG) is characterized by reduced serum immunoglobulin (Ig) levels and is typically caused by immunosuppressive therapy or certain diseases. Patients with systemic autoimmune rheumatic diseases (SARDs) and hematological malignancies are particularly susceptible to developing SHG due to underlying diseases and the use of immunosuppressive medications, such as B-cell-targeted agents. Consequently, SHG significantly contributes to increased risks of severe infections and mortality in SARDs patients. Considering the lack of a unified strategy for managing SHG, the Taiwan College of Rheumatology (TCR) aimed to formulate consensus recommendations for the screening, diagnosis, and management of SHG. These recommendations were developed based on emerging evidence during a face-to-face meeting of the TCR committee (nine immunologists and rheumatologists), and utilizing the modified Delphi process. This meeting involved a comprehensive review of the current evidence, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Thirteen consensus recommendations were developed to emphasize the importance of early detection and optimal treatment of SHG. Furthermore, effective prevention of infections through risk assessment alongside timely and regular monitoring of IgG levels was highlighted. The recommendations also included anti-infective therapies and intravenous Ig replacement, offering valuable guidance to rheumatologists in managing SHG. This consensus will be regularly updated as newer evidence emerges.
Published by International journal of rheumatic diseases, 2025. The PDF is shown as published and remains the work of its authors and publisher; the original is at the source linked here. Rights holders can ask us to remove a file at info@prognia.nl.
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