Sir.—Pick et al in their interesting article in the Journal (131:682-686, 1977) described a case of agammaglobulinemia characterized by the absence of IgG, IgA, IgD, and the salivary "secretory component" associated with a plasma cell dyscrasia and amyloidosis. They include a summary of the findings in other cases of amyloidosis associated with agammaglobulinemia.
One report that they did not include was relevant to the subject. I refer to the article by Ziegler and Penny1 in which they described the first reported case of X-linked hypogammaglobulinemia associated with amyloidosis. The patient, a 14-year-old boy, died of meningoencephalitis and its sequelae, and at autopsy amyloid was detected in the liver, thymus, tonsils, and kidney.
I would also like to correct an inaccuracy in the comment by Pick et al. They state that seven of ten cases discussed by Mawas et al2 seem to have a "mixed pattern" of amyloid deposition
GAFFNEY EF. Agammaglobulinemia. Am J Dis Child. 1978;132(8):818. doi:10.1001/archpedi.1978.02120330090022