Specific antibody deficiency

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  • Failure to respond to an unconjugated polysaccharide vaccine despite otherwise normal immune evaluation
  • Characterized by recurrent community-acquired pneumonia
  • Investigated by giving pneumococcal 23-valent polysaccharide vaccine and measuring titres 4 to 6 weeks later
    • Serotype specific titres should be ≥1.3 μg/mL or 2-fold increase; if not, it suggests specific antibody deficiency
  • Management is immunization with the conjugated 13-valent pneumococcal vaccine