Selective deficiency of IgA
IgA deficiency; Immunodepressed - IgA deficiency; Immunosuppressed - IgA deficiency; Hypogammaglobulinemia - IgA deficiency; Agammaglobulinemia - IgA deficiency
Selective deficiency of IgA is the most common immune deficiency disorder . People with this disorder have a low or absent level of a blood protein called immunoglobulin A.
Immune deficiency disorder
Immunodeficiency disorders occur when the body's immune response is reduced or absent.
Causes
IgA deficiency is usually inherited, which means it is passed down through families. However, cases of drug-induced IgA deficiency have been reported.
It may be inherited as an autosomal dominant or autosomal recessive trait. It is usually found in people of European origin. It is less common in people of other ethnicities.
Autosomal dominant
Autosomal dominant is one of several ways that a trait or disorder can be passed down (inherited) through families. In an autosomal dominant disease,...
Autosomal recessive
Autosomal recessive is one of several ways that a trait, disorder, or disease can be passed down through families. An autosomal recessive disorder me...
Symptoms
Many people with selective IgA deficiency have no symptoms.
If a person does have symptoms, they may include frequent episodes of:
-
Bronchitis
(airway infection)
Bronchitis
Acute bronchitis is swelling and inflamed tissue in the main passages that carry air to the lungs. This swelling narrows the airways, which makes it...
- Chronic diarrhea
-
Conjunctivitis
(eye infection)
Conjunctivitis
The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Conjunctivitis occurs when the conjunctiva becomes...
-
Gastrointestinal inflammation, including (
ulcerative colitis
,
Crohn disease
, and a
sprue-like illness
Ulcerative colitis
Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...
Crohn disease
Crohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...
Sprue-like illness
Celiac disease is a condition caused by damage to the lining of the small intestine. This damage comes from a reaction to eating gluten. This is a ...
- Mouth infection
-
Otitis media
(middle ear infection)
Otitis media
Ear infections are one of the most common reasons parents take their children to the doctor. The most common type of ear infection is called otitis ...
-
Pneumonia
(lung infection)
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
-
Sinusitis
(sinus infection)
Sinusitis
Sinusitis is present when the tissue lining the sinuses become swollen or inflamed. It occurs as the result of an infection from a virus, bacteria, ...
- Skin infections
- Upper respiratory tract infections
Other symptoms include:
-
Bronchiectasis
(a disease in which the small air sacs in the lungs become damaged and enlarged)
Bronchiectasis
Bronchiectasis is a disease in which the large airways in the lungs are damaged. This causes the airways to become wider. Bronchiectasis can be pres...
-
Asthma
without a known cause
Asthma
Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughi...
Exams and Tests
There may be a family history of IgA deficiency. Tests that may be done include:
- IgG subclass measurements
-
Quantitative immunoglobulins
Quantitative immunoglobulins
Quantitative nephelometry is a lab test to quickly and accurately measure levels of certain proteins called immunoglobulins in the blood. Immunoglob...
-
Serum immunoelectrophoresis
Serum immunoelectrophoresis
Serum immunoelectrophoresis is a lab test that measures proteins called immunoglobulins in the blood. Immunoglobulins are proteins that function as ...
Treatment
No specific treatment is available. Some people gradually develop normal levels of IgA without treatment.
Treatment involves taking steps to reduce the number and severity of infections. Antibiotics are often needed to treat bacterial infections.
Immunoglobulins are given through a vein or by injection to boost the immune system.
Autoimmune disease treatment is based on the specific problem.
Note: People with complete IgA deficiency may develop anti-IgA antibodies if given blood products and immunoglobulins. This may lead to allergies or life-threatening anaphylactic shock . However, they can safely be given IgA-depleted immunoglobulins.
Allergies
An allergy is an immune response or reaction to substances that are usually not harmful.
Anaphylactic shock
Anaphylaxis is a life-threatening type of allergic reaction.
Outlook (Prognosis)
Selective IgA deficiency is less harmful than many other immunodeficiency diseases.
Some people with IgA deficiency will recover on their own and produce IgA in larger quantities over a period of years.
Possible Complications
Autoimmune disorders such as rheumatoid arthritis , systemic lupus erythematosus , and celiac sprue may develop.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term disease. It leads to inflammation of the joints and surrounding tissues. It can also affect other organs....
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the body's immune system mistakenly attacks healthy tissue. It can af...
Celiac sprue
Celiac disease is a condition caused by damage to the lining of the small intestine. This damage comes from a reaction to eating gluten. This is a ...
People with IgA deficiency may develop antibodies to IgA. As a result, they can have severe, even life-threatening reactions to transfusions of blood and blood products.
When to Contact a Medical Professional
If you have an IgA deficiency, be sure to mention it to your health care provider if immunoglobulin or other blood-component transfusions are suggested as a treatment for any condition.
Prevention
Genetic counseling may be of value to prospective parents with a family history of selective IgA deficiency.
References
Buckley RH. Primary defects of antibody production. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 124.
Cunningham-Rundles C. Primary immunodeficiency diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 250.
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 3/20/2016
Reviewed By: Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.