Serum globulin deficiencies in non-tropical sprue, with report of two cases of acquired agammaglobulinemia

MONG the published cases of acquired agamA maglobulinemia, a sprue-like syndrome has been reported in at least eight [7-81; Gitlin and associates [9] estimated the incidence of this syndrome in such cases as about 20 per cent. Such an incidence appears to be far too great to be altogether coincidental. Our study of serum globulins in sprue was stimulated by the observation of two cases in which non-tropical sprue and agammaglobulinemia coexisted. It is our aim to report these two cases and to present evidence, obtained from a review of the records in 124 cases of non-tropical sprue, that deficiencies in serum globulin, with or without associated reductions in serum albumin, occur frequently in this disease. These data and also an increase in the concentration of gamma globulin toward normal in one of our patients during a remission of sprue suggest that malabsorption may be an important causative factor in some cases of acquired agammaglobulinemia.