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To the Editor:—
Dr. Barrett says our cases do not fit the accepted criteria for hypogammaglobulinemia, which is quite rare. We took pains to show that they are not true hypogammaglobulinemia (i.e., they do respond to antigens and they have isohemagglutinins), which is why we clearly labeled this a "variant" in our subtitle; and that this is much more common than the classic case. Since the original writing, I have found 15 more cases in my own practice and Dr. Spencer has found 6 more in his.The variety of symptoms in these patients, to which Dr. Barrett objects, is one of our main points. Classic cases all included some form of pneumonic infection (Good and Mazzitello, Dis Chest, 29:9-35 [Jan.] 1956). Most of our cases did not. Dr. Barrett says "They claim that these children then had less allergy, fewer viral respiratory infections, etc." Most of these infections
Gordon BD. Hypogammaglobulinemia ogammaglobulinemia-Reply. JAMA. 1961;175(8):729-730. doi:10.1001/jama.1961.03040080084029