Serum Immunoglobulin Levels in IgA Deficiency

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AAAAI 56th Annual Meeting

Abstract No.: 650

Serum Immunoglobulin Levels in IgA Deficiency

CV Guerra, J Kalil, MT Barros

Division of Allergy and Immunopathology, University Sao o, Brazil

Subject: 23 Immunodeficiency

Keywords:

Most of individuals with immunoglobulin A deficiency (IgA-D) are healthy

but a minority have symptoms such as recurrent infections, atopy,

autoimmunity, and neoplasias. There are no dates on prognosis for IgA

deficient children, but there is a tendency to improve with age. On rare

occasions IgA-D may precede the development of more generalised

hypogammaglobulinemia. The purpose of this study was to analyse

retrospectively the outcome of serum immunoglobulin levels in patients with

IgAD. Sixty nine IgA deficient patients, 37 males and 32 females with ages

ranging from 2 to 57 yrs) were studied. between 1977 and september 1999.

Forty-four individuals had total IgA deficiency ( T-IgA-D - serum IgA < 5

mg/dl) and 25 individuals had partial IgA deficiency ( P-IgA-D - IgA serum >

5 mg/dl and < 2 SDs mean-adjusted age). Among patients with T-IgA-D or

P-IgA-D were observed, respectively: 5 (15.6%) and 3 (20%) cases of isolated

atopy; 21 (65.6%) and 8 (53.3%) cases of atopic diseases and recurrent

infections; and 2 (18.7%) and 2 (13.3%) cases of isolated recurrent

infections. Four patients with T-IgA-D had autoimmune diseases associated

with recurrent infections. Only 2 patients were asymptomatic when P-IgA

deficiency was first detected. All patients were followed between 0.5 and 13

years. Initial diagnosis of total or partial IgA-D remained unchanged in 39

(88.6%) of T-IgA-D patients and 17 (66%) of P-IgA-D patients; IgA levels

attained normal values in 2 (4.%) of T-IgA-D patients ( 4 yrs and 37 yrs

old) and in 4 (20%) of P-IgA-D patients ( ages ranging from 12 yrs to 19

yrs); IgA levels increased without attaining normal values in two patients

of each group. Two patients (one in each group) progressed to common

variable immunodeficiency 4 years and 4 months after initial diagnosis of

total and partial IgA-D, respectively Similar results are found in the

literature, suggesting that serum IgA levels may become normal any time, and

that on rare occasions IgA-D may progressed to hypogammaglobulinemia.

*FAPESP No. 98/00164-1