Serum immunoglobulin levels in children after splenectomy. A prospective study.

Serum immunoglobulin concentrations (IgG, IgA, and IgM) were measured in 34 children before and after splenectomy. Splenectomy was performed either after trauma or for an underlying hematologic disorder. In the patients with a hematologic disorder, we found a significant decrease in the IgM level after splenectomy. The IgM concentration remained low for a two-year period. Those patients who were "afebrile" during the study period had the lowest IgM levels. No significant changes were observed in the IgM levels in the group that underwent a splenectomy because of trauma. No significant changes were found in IgG or IgA levels in either group. A low IgM level in patients with hematologic disorders may have contributed to a defect in opsonization and to a high incidence of overwhelming infection soon after splenectomy in this group. In the group that underwent a splenectomy because of trauma, the normal IgM level may have protected them and contributed to the lower incidence of infection in this group.