Antibody Production to Aggregated Human γg-Globulin in Acquired Hypogammaglobulinemia

A patient with acquired hypogammaglobulinemia, who suffered "anaphylactic shock" after intramuscular administration of commercially prepared human γG-globulin (HGG), was found on gel diffusion analysis to have precipitating antibody specific for the aggregated form of HGG. The antibody was principally of the γG-globulin type, and could be differentiated from classic rheumatoid factor by a number of hemagglutination technics. Unlike rheumatoid factor, the antibody failed to agglutinate sheep red cells sensitized with rabbit γG-globulin antibody, nor would it agglutinate latex particles coated with native HGG. The antibody readily agglutinated human A cells coated with homologous human γG-globulin antibody, however, and also agglutinated latex particles coated with aggregated HGG. Because of the specificity of this antibody, its coincident appearance and its increase after a period of considerable γ-globulin "immunization," it is postulated that its occurrence resulted from the administration of γG-globulin aggregates present in the preparations used for therapy.