Abstract
Background: IgA deficiency is the most common primary immunodeficiency. Early diagnosis and clinical follow-up may improve the quality of life of patients with IgA deficiency. To this end, IgA deficiency should be further studied and better understood on its clinical manifestations.
Objective: To determine IgA deficiency clinical manifestations.
Methods: Cross-sectional, retrospective, exploratory study, where the medical records of 39 patients with IgA deficiency were analyzed.
Results: Among the analyzed cases, 10 patients were diagnosed with total IgA deficiency and 29 patients with partial IgA deficiency. Partial and total IgA deficiency main clinical manifestations were allergic rhinoconjunctivitis and allergic asthma. In total IgA deficiency, in addition to allergic diseases, a statistically significant number (P < 0.05) of cases of infection-related rhinosinusitis, tonsillitis and conjunctivitis were also observed.
Conclusion: This study showed that the main clinical manifestations in IgA deficiency were allergic rhinoconjunctivitis and allergic asthma. In addition, patients with total IgA deficiency showed a significant increase in infection-related rhinosinusitis, tonsillitis and conjunctivitis, when compared with patients with partial IgA deficiency.
References
Mestecky J, McGhee JR. Immunoglobulin A (IgA): Molecular and cellular interactions involved in IgA biosynthesis and immune response. Adv Immunol. 1987;40:153-245.
Hernández-Martínez C, Espinosa-Rosales F, Espinosa-Padilla SE, Hernández-Martínez AR, Blancas-Galicia L. Conceptos básicos de las inmunodeficiencias primarias. Rev Alerg Mex. 2016;63(2):180-189. Disponible en: http://revistaalergia.mx/ojs/index.php/ram/article/download/146/270
Jorgensen GH, Gardulf A, Sigurdsson MI, Sigurdardottir STH, Thorsteinsdottir I, Gudmundsson S, et al. Clinical symptoms in adults with selective iga deficiency: A case-control study. J Clin Immunol. 2012;3374):742-747. DOI: http://dx.doi.org/10.1007/s10875-012-9858-x
Kutukculer N, Edeer N, Karaca, Demircioglu O, Aksu G. Increases in serum immunoglobulins to age-related normal levels in children with IgA and/or IgG subclass deficiency. Pediatr Allergy Immunol. 2007;18(2):167-173. DOI: 10.1111/j.1399-3038.2006.00491.x
Notarangelo L, Casanova JL, Conley ME, Chapel H, Fisher A, Puck J, et al. Primary immunodeficiency diseases: An update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee Meeting in Budapest, 2005. J Allergy Clin Immunol. 2006;117(4):883-896.
Yel L. Selective IgA deficiency. J Clin Immunol. 2010;30:10-6. DOI: http://dx.doi.org/10.1007/s10875-009-9357-x
Carvalho Neves-Forte W, Ferreira-de Carvalho Júnior F, Damaceno N, Vidal Perez FG, Gonzales Lopes C, Mastroti RA. Evolution of IgA deficiency to IgA subclass deficiency and common variable immunodeficiency. Allergol Immunopathol. 2000;28(1):18-20. Disponible en: http://www.elsevier.es/en-revista-allergologia-et-immunopathologia-105-articulo-evolution-iga-deficiency-igg-subclass-13011415
Lourenço DB, Munhoz DC, Bariani DB, Zanini KM, Menezes MCS, Mosca T, Carvalho Neves Forte W. Prevalência de rinite alérgica em deficiência de IgA. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo. 2012;57(2):63-66. Disponible en: http://www.fcmsantacasasp.edu.br/images/Arquivos_medicos/2012/57_2/03-AO38.pdf
Grumach AS, Jacob CMA, Pastorino AC. Deficiência de IgA: Avaliação clínico-laboratorial de 60 pacientes do Instituto da Criança. Rev Assoc Med Bras. 1998;44(4):277-82.
Rúpolo BS, Mira JGS, Junior OK. Deficiência de IgA. J Pediatr. 1998;74:433-40. DOI: http://dx.doi.org/10.1590/S0104-42301998000400005
Rivas JJ, Brocardo GA, Kokron C, Rizzo LV, Kalil J, Barros MT. Caracterização imunofenotípica de linfócitos B de memória na deficiência de IgA e imunodeficiência comum variável. Rev Bras Alergia Imunopatol. 2010(1);33:23-31. Disponible en: http://www.sbai.org.br/revistas/Vol331/ART%201-10%20-%20Caracteriza%C3%A7%C3%A3o%20imunofenot%C3%ADpica%20de%20linf%C3%B3citos%20B.pdf
Hammarstrom L, Vorechovsky I, Webster D. Selective IgA deficiency (SIgAD) and common variable immunodeciency (CVID). Clin Exp Immunol. 2000;120(2):225-231. DOI: http://dx.doi.org/10.1046/j.1365-2249.2000.01131.x
Aghamohammadi A, Mohammadi J, Parvaneh N, Rezaei N, Moin M, Espanol T, Hammarstrom L. Progression of selective IgA deficiency to common variable immunodeficiency. Int Arch Allergy Immunol. 2008;147(2):87-92. DOI: http://dx.doi.org/10.1159/000135694
Blanco-Quirós A, Solís-Sánchez P, Garrote-Adrados JA, Arranz-Sanz E. Common variable immunodeficiency. Old questions are getting clearer. Allergol Immunopathol. 2006;34(6):263-275.
Carvalho Neves Forte W. Imunologia do básico ao aplicado. Tercera edición. São Paulo: Atheneu; 2015. p. 221-249.
Sociedade Europeia de Imunodeficiências (ESID). Sitio web. www.esid.org
Abbas AK, Lichtman AH, Pillai S. Propriedades gerais das respostas imunes. En: Abbas AK, Lichtman AH, editores. Imunologia celular e molecular. Séptima edición. España: Elsevier; 2012. p. 2-14.
Özcan C, Metin A, Erkoçoglu M, Kocabas CN. Bronchial hyperreactivity in children with antibody deficiencies. Allergol Immunopathol (Madr). 2015;43(1):57-61. DOI: http://dx.doi.org/0.1016/j.aller.2013.09.014
Janzi M, Kull I, Sjöberg R, Wan J, Melén E, Bayat N, et al. Selective IgA deficiency in early life: Association to infections and allergic diseases during childhood. Clin Immunol. 2009;133(1):78-85. DOI: http://dx.doi.org/10.1016/j.clim.2009.05.014

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