What is agammaglobulinemia?
Agammaglobulinemia, which is usually abbreviated as AGMX, is a kind of disease that has a genetic origin. By genetic origin, I mean, it is an inherited disease, a bad gift from a mother to her unborn child. It is only a mother that can transmit it to her child. You should ask me why! But never mind, I will explain why it is so. A woman has XX chromosome. During fertilization, one of this X will be donated to either the X or Y chromosome of a man. A man has XY chromosome. The bad gene is always located in any of the two X chromosomes of the woman. Since only one X can be donated during fertilization, she cannot decide which one to donate. It is a probability. If she eventually donates the affected X chromosome the resulting baby that will be formed will either be a carrier or will be affected. The carrier will be a girl while the affected will be a boy. This is so because the girl receives the father’s X chromosome, which is a good one. The boy, on the other hand, receives his mother’s bad X chromosome. And what you need to know is that each of these chromosomes has their functions. A chromosome cannot perform its functions if it is bad. X chromosomes have a specific function in both males and female. Now, in this case, the X chromosome contains codes that are responsible for the production of antibodies. Now that the boy has a bad X chromosome, his body cannot do that. That is where the problem arises. The girl, on the other hand, being a carrier, will still be able to produce antibodies from the other good X chromosome she inherited from her father even when she has that bad X she has received from her mother. That is why girls are rarely affected with agammaglobulinemia.
You can also call agammaglobulinemia, X-linked agammaglobulinemia, Bruton’s agammaglobulinemia or congenital agammaglobulinemia. It was the very first disease of the immune system ever discovered
Agammaglobulinemia means an absence of gamma globulin in the blood. Gamma globulin is an antibody. Antibodies make up the immune system of the body. They are the body’s defense system. They fight infections and get rid of anything that has the ability to hurt the body.
Causes of agammaglobulinemia
The cause is BTK. BTK is Bruton’s tyrosine kinase. It is the gene responsible for the production of gamma globulin. It is responsible for that because it has been mutated; its structure has been altered. Because it has been mutated, it cannot perform its functions- production of gamma globulins.
How this is transferred from a parent to a child has already been explained.
Agammaglobulinemia only needs a single bad copy a gene to express itself. That is why it is called an X-linked disease or inheritance.
Photo Credit: Healthline
Symptoms of agammaglobulinemia
Symptoms should be looked out for in kids especially boys who are about 6 to 9 months old. From 6 months downwards, it is the mother’s antibodies that protect the child because, by this time, the child has not begun producing his own. That is why you will not see symptoms during this period but from 6 months upwards. Once this time has elapsed, you will now begin to see the child show some symptoms because he cannot produce his own antibodies. Some can even present symptoms later than this time, say 3-5 years after. It is possible for girls to show very mild symptoms since they are carriers. You just have to be very observant of your kids. Common symptoms include;
- Gastrointestinal infections and inflammation e.g. chronic diarrhea
- Viral infections: Examples include polio, hepatitis etc.
- Nasal infection and inflammation
- Infections of the eyes
- Infections of the lungs
- Infections of the skin
- Infections of the bones
- Infections of the bronchi
- Infections of the spinal cord
- Infections of the ears
- Inflammation and cancer of the kidneys
- Disease of the joint
- Infection, cancer, and hemolysis of the blood. Hemolysis of the blood is the breaking down of red blood cells.
- Inflammation of the skin and muscles
- Low blood neutrophils
- Poor growth and development
Kids without Agammaglobulinemia can also present these symptoms but the difference is that affected kids have them more severely and are frequently sick.
Diagnosis for agammaglobulinemia
Your doctor will first have to take the medical history of your child before he goes ahead to carry out a physical and laboratory examinations on him.
The laboratory tests that will be conducted are to assess the state of his immune system especially the antibodies. His blood will be tested for hemolysis and immune system anomalies. The following tests will also be conducted to assess his antibodies level and functions; quantitative immunoglobulins, immunoelectrophoresis, and flow cytometry.
Treatment for agammaglobulinemia
Before commencing treatment on the child, certain things should be taken into consideration. This is the responsibility of your doctor.
Factors to be considered are;
- The age of your child
- His general wellbeing
- His medical history
- And how severe his condition is
Once your doctor has determined all of that, a treatment regimen called gamma globulin therapy will be given to him. This therapy is to replace antibodies in the blood of your child. Once these antibodies have been injected into his blood, they will begin to fight all the infections in his body.
It is important to note that kids with AGMX are expected to;
- Always go for treatment immediately they have an infection or illness whatsoever. Why? Because their body does not have the capacity to fight infections. They have to receive a support for that from an injection.
- Desist from taking viral vaccinations that are life because a live viral vaccine, rather than prevent, is a trigger to the development of the disease
Countless reports have it that kids affected with AGMX have the ability to enjoy healthy lives like every other kid. Notwithstanding, attention must be given to their early diagnosis and treatment because a body without antibodies is like a house without a roof. It means their body defense mechanism is absent. It means they will not be able to fight infections. That is the more reason they should not be neglected; they might not survive it because a lack of antibodies in their blood will result in chronic tissues damaging infections and inflammation will erupt. And theses damaging effects might not be reversible.
And early diagnosis and treatment is also not a guarantee that they will live long. It is that dicey.
Prevention of agammaglobulinemia
To prevent your child from having this disease, particularly if you have a history of such cases in your family, make sure you without hesitation visit your doctor once you realize that you are pregnant. It is when you do this that you and your unborn child can be helped out.
You are to see him for genetic counseling. He will also find out if you are a carrier of that defective gene responsible for the disease. If that is so, it means the possibility of your unborn child inheriting the gene is fifty-fifty. He will have to swing into action to ensure that your unborn child is properly treated. Or you can even choose to terminate the pregnancy.