Functional assessment of T and B lymphocytes in patients with selective IgM deficiency.

Two patients with selective IgM deficiency were studied. Both presented with dermatitis, chronic diarrhoea, recurrent respiratory infections, failure to thrive, elevated serum IgE levels and in vivo impairment of antibody production. No phagocytic or complement abnormalities were found. B lymphocytes with surface IgM were present in normal or high percentage in peripheral blood, and produced normal amounts of IgM in vitro when co-cultured with normal T cells. Patients' T cells did not show excess suppressor function in vitro but had a decreased helper activity for IgM, IgG and IgA production. It is suggested that both patients have an extensive humoral immune deficiency that might be caused by the immunoregulatory T cell defect.