Assessing humoral immunity in daily practice: A retrospective study in a pediatric tertiary center
Bibliographic record
Abstract
The evaluation of humoral immunity is usually performed through the assessment of serum immunoglobulin levels, vaccine titer responses, and B-cell enumeration and phenotyping. We performed a retrospective study assessing humoral immunity in 469 pediatric patients referred at the Sainte-Justine University Hospital Center. Almost half of the patients had at least one abnormal humoral immunological parameter at their evaluation, with low vaccine response titer to protein antigen being the most frequent. Fifteen patients (3.2 %) had a proven monogenic IEI, and 21 patients (4.5 %) required Ig replacement. Besides the infectious burden, hypoIgG remains the only parameter associated with Ig replacement therapy after the age of 6 years. Low antibody titers against conjugate vaccines had low sensitivity and positive predictive values for starting Ig replacement. Our study highlights the challenge of evaluating the humoral function in the pediatric population with suspected IEI with significant age and sex-dependent variability between parameters. • In front of patients with suspected humoral deficiency, while the infectious burden remains the main trigger for starting Ig replacement, hypoIgG remains the only biological parameter clearly associated with Ig substitution. • Except for BTK deficiency, persistent hypo IgG seems to unveil mainly in patients older than 5 years old suggesting that prolonged clinical follow-up should be maintained for patients before ruling out potential immunodeficiency • Adequate interpretation of vaccine titers response towards protein antigen needs to integrate the patient • age, sex, number of vaccine doses and the time interval between biological assessment and last vaccine dose.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.005 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".